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General NPI Number Information
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NPI Number | 1780239228
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Entity Type | Organization
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Legal Business Name | HATBORO DENTAL & SPECIALTY LLC
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Dates
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Enumeration Date | 08/01/2019
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Last Update Date | 08/01/2019
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Provider Practice Location Address
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Address Line | 122 N YORK RD STE 2
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City | HATBORO
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State | PA
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Zip | 19040-2622
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Country | US
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Telephone | 215-443-5400
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Fax | 215-957-0334
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Provider Business Mailing Address
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Address Line | 122 N YORK RD STE 2
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City | HATBORO
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State | PA
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Zip | 19040-2622
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Country | US
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Telephone | 215-443-5400
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Fax | 215-957-0334
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Authorized Official
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Title or Position | OWNER
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Name | BENJAMIN SCHNEIDER
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Credential | DMD
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Telephone | 215-443-5400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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