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General NPI Number Information
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NPI Number | 1790844082
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Entity Type | Individual
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Provider Name | JEREMY S RICH D.M.D., M.S.
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Gender | Male
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Dates
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Enumeration Date | 12/06/2006
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Last Update Date | 12/23/2009
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Provider Practice Location Address
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Address Line | 3554 HULMEVILLE RD SUITE 110
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City | BENSALEM
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State | PA
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Zip | 19020-4366
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Country | US
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Telephone | 508-954-2348
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Fax |
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Provider Business Mailing Address
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Address Line | 22 S FRONT ST APT 305
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City | PHILADELPHIA
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State | PA
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Zip | 19106-3354
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Country | US
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Telephone | 508-954-2348
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | DS036660
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License Number State | PA
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