Provider Demographics
NPI:1982914875
Name:READING HYBRIDGE, P.C.
Entity Type:Organization
Organization Name:READING HYBRIDGE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:HABAKUS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:610-385-0703
Mailing Address - Street 1:1008 BEN FRANKLIN HWY W
Mailing Address - Street 2:
Mailing Address - City:DOUGLASSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19518-1035
Mailing Address - Country:US
Mailing Address - Phone:610-385-0703
Mailing Address - Fax:610-385-4995
Practice Address - Street 1:1008 BEN FRANKLIN HWY W
Practice Address - Street 2:
Practice Address - City:DOUGLASSVILLE
Practice Address - State:PA
Practice Address - Zip Code:19518-1035
Practice Address - Country:US
Practice Address - Phone:610-385-0703
Practice Address - Fax:610-385-4995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-14
Last Update Date:2010-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS029070L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty