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General NPI Number Information
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NPI Number | 1750866273
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Entity Type | Organization
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Legal Business Name | IE DENTAL SERVICES PC
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Dates
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Enumeration Date | 10/01/2018
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Last Update Date | 11/19/2018
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Provider Practice Location Address
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Address Line | 501 FLORAL VALE BLVD
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City | YARDLEY
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State | PA
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Zip | 19067-5512
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Country | US
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Telephone | 215-504-2400
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Fax | 215-504-7450
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Provider Business Mailing Address
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Address Line | 501 FLORAL VALE BLVD
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City | YARDLEY
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State | PA
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Zip | 19067-5512
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Country | US
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Telephone | 215-504-2400
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Fax | 215-504-7450
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PURVI R PATEL
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Credential | DDS
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Telephone | 215-504-2400
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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