Healthcare Provider Details

I. General information

NPI: 1033488291
Provider Name (Legal Business Name): TICKLE TOOTH HOLDINGS P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2011
Last Update Date: 01/22/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

235 S POTTSTOWN PIKE
EXTON PA
19341-2747
US

IV. Provider business mailing address

2217 BALTIMORE PIKE
OXFORD PA
19363-4013
US

V. Phone/Fax

Practice location:
  • Phone: 610-363-8872
  • Fax:
Mailing address:
  • Phone: 610-444-1331
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License NumberDS030525L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDS030525L
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. ERIC FELIX
Title or Position: PRESIDENT
Credential: DMD
Phone: 610-363-8872