MEDICARE: DR. SAM KADAN 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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	DS029391L	PA

General Provider Information

NPI Number	:	1104926104
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SAM KADAN DMD

Provider Business Mailing Address
First Line	:	1500 HORIZON DR
Second Line	:	SUITE 107
City	:	CHALFONT
State	:	PA
Zip	:	18914-3966
Country	:	US
Telephone Number	:	215-997-0599
Fax Number	:	215-997-0410

Provider Business Practice Location Address
First Line	:	1500 HORIZON DR
Second Line	:	SUITE 107
City	:	CHALFONT
State	:	PA
Zip	:	18914-3966
Country	:	US
Telephone Number	:	215-997-0599
Fax Number	:	215-997-0410

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

Provider Enumeration Date	:	09/22/2006
Last Update Date	:	07/08/2007

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