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General NPI Number Information
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NPI Number | 1659191120
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Entity Type | Organization
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Legal Business Name | COLLINGDALE DENTAL ARTS PC
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Dates
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Enumeration Date | 10/10/2024
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Last Update Date | 10/10/2024
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Provider Practice Location Address
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Address Line | 224 CLIFTON AVE
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City | COLLINGDALE
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State | PA
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Zip | 19023-4050
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Country | US
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Telephone | 610-583-3454
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Fax |
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Provider Business Mailing Address
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Address Line | 118 AVONDALE DR
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City | NORTH WALES
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State | PA
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Zip | 19454-3900
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Country | US
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Telephone | 267-640-8277
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. ASHWANI BATRA
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Credential |
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Telephone | 610-583-3454
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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