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General NPI Number Information
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NPI Number | 1083850416
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Entity Type | Organization
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Legal Business Name | WEST CHESTER ENDODNTICS, PC
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Dates
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Enumeration Date | 01/07/2009
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Last Update Date | 02/11/2009
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Provider Practice Location Address
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Address Line | 606 E MARSHALL ST SUITE 204
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City | WEST CHESTER
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State | PA
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Zip | 19380-4467
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Country | US
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Telephone | 610-431-7025
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Fax | 610-431-7027
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Provider Business Mailing Address
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Address Line | 606 E MARSHALL ST SUITE 204
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City | WEST CHESTER
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State | PA
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Zip | 19380-4467
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Country | US
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Telephone | 610-431-7025
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Fax | 610-431-7027
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SAMUEL I KRATCHMAN
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Credential | DMD
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Telephone | 610-431-7025
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | DS027045L
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License Number State | PA
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