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General NPI Number Information
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NPI Number | 1558697201
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Entity Type | Organization
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Legal Business Name | RICH ORTHODONTICS, LLC
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Dates
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Enumeration Date | 10/29/2009
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Last Update Date | 10/29/2009
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Provider Practice Location Address
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Address Line | 3554 HULMEVILLE RD 110
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City | BENSALEM
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State | PA
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Zip | 19020-4366
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Country | US
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Telephone | 215-244-9505
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Fax | 215-244-0167
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Provider Business Mailing Address
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Address Line | 22 S FRONT ST 305
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City | PHILADELPHIA
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State | PA
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Zip | 19106-3354
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Country | US
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Telephone | 508-954-2348
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Fax | 267-772-7665
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Authorized Official
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Title or Position | OWNER-ORTHODONTIST
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Name | DR. JEREMY SCOTT RICH
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Credential | D.M.D
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Telephone | 508-954-2348
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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 | DS036660
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License Number State | PA
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