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General NPI Number Information
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NPI Number | 1316560592
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Entity Type | Organization
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Legal Business Name | LAKEVIEW ORTHODONTICS PLLC
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Dates
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Enumeration Date | 05/22/2020
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Last Update Date | 05/22/2020
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Provider Practice Location Address
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Address Line | 959 S TOWNSHIP LINE RD STE G
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City | ROYERSFORD
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State | PA
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Zip | 19468-1823
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Country | US
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Telephone | 215-964-7920
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Fax |
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Provider Business Mailing Address
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Address Line | 8140 ARLINGTON AVE
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City | UPPER DARBY
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State | PA
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Zip | 19082-2711
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ORTHODONTIST
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Name | DR. HAMID HASHEMI
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Credential | DMD, MS, MBA
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Telephone | 215-964-7920
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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