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General NPI Number Information
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NPI Number | 1669918090
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Entity Type | Organization
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Legal Business Name | QUALDENT
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Dates
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Enumeration Date | 01/09/2017
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Last Update Date | 01/09/2017
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Provider Practice Location Address
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Address Line | 2600 PHILMONT AVE SUITE 212-A
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City | HUNTINGDON VALLEY
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State | PA
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Zip | 19006-5306
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Country | US
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Telephone | 610-619-0061
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Fax |
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Provider Business Mailing Address
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Address Line | 2600 PHILMONT AVE SUITE 212-A
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City | HUNTINGDON VALLEY
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State | PA
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Zip | 19006-5306
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Country | US
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Telephone | 610-619-0061
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. DAVID WILLIAMS
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Credential |
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Telephone | 609-760-6256
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 1275727430
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License Number State | NJ
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