MEDICARE: DR. JEFFREY J SANTANELLO DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	0401411462	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023175924
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFFREY J SANTANELLO DMD

Provider Business Mailing Address
First Line	:	1700 HORIZON DRIVE
Second Line	:	SUITE 101
City	:	CHALFONT
State	:	PA
Zip	:	18914-3950
Country	:	US
Telephone Number	:	215-997-0740
Fax Number	:	215-997-0743

Provider Business Practice Location Address
First Line	:	1700 HORIZON DRIVE
Second Line	:	SUITE 101
City	:	CHALFONT
State	:	PA
Zip	:	18914-3950
Country	:	US
Telephone Number	:	215-997-0740
Fax Number	:	215-997-0743

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/02/2007
Last Update Date	:	11/01/2011

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