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General NPI Number Information
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NPI Number | 1699874784
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Entity Type | Organization
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Legal Business Name | RICHARD A. TANZILLI, II, D.M.D., P.C.
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Dates
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Enumeration Date | 09/22/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1246 W CHESTER PIKE SUITE 306
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City | WEST CHESTER
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State | PA
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Zip | 19382-5683
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Country | US
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Telephone | 610-431-7350
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Fax |
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Provider Business Mailing Address
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Address Line | 1246 W CHESTER PIKE SUITE 306
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City | WEST CHESTER
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State | PA
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Zip | 19382-5683
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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 | PRESIDENT
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Name | RICHARD A. TANZILLI II
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Credential | D.M.D.
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Telephone | 610-431-7350
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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 | DS026968L
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License Number State | PA
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