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General NPI Number Information
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NPI Number | 1336685320
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Entity Type | Organization
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Legal Business Name | CHESTER COUNTY ORTHODONTICS
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Dates
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Enumeration Date | 01/13/2017
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Last Update Date | 01/21/2025
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Provider Practice Location Address
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Address Line | 795 E MARSHALL ST STE 200
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City | WEST CHESTER
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State | PA
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Zip | 19380-4400
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Country | US
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Telephone | 610-918-2400
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Fax |
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Provider Business Mailing Address
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Address Line | 2300 LAKEVIEW PKWY STE 250
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City | ALPHARETTA
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State | GA
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Zip | 30009-3954
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Country | US
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Telephone | 470-207-3264
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Fax | 678-550-5490
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Authorized Official
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Title or Position | CFO
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Name | BRIAN SMITH
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Credential |
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Telephone | 770-231-5348
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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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