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General NPI Number Information
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NPI Number | 1073904454
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Entity Type | Organization
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Legal Business Name | ADVANCED DENTISTRY OF WESTTOWN PC
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Dates
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Enumeration Date | 02/06/2015
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Last Update Date | 02/17/2015
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Provider Practice Location Address
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Address Line | 1580 MCDANIEL DR
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City | WEST CHESTER
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State | PA
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Zip | 19380-6673
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Country | US
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Telephone | 610-431-3310
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Fax |
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Provider Business Mailing Address
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Address Line | 1580 MCDANIEL DR
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City | WEST CHESTER
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State | PA
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Zip | 19380-6673
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Country | US
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Telephone | 610-431-3310
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DILIP DUDHAT
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Credential |
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Telephone | 610-431-3310
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DS029728
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License Number State | PA
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