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General NPI Number Information
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NPI Number | 1831597707
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Entity Type | Organization
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Legal Business Name | ADVANCED AND ELITE DENTISTRY PC
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Dates
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Enumeration Date | 12/09/2014
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Last Update Date | 12/09/2014
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Provider Practice Location Address
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Address Line | 201 SECOND AVE
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City | COLLEGEVILLE
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State | PA
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Zip | 19426-3613
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Country | US
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Telephone | 610-454-7991
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Fax |
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Provider Business Mailing Address
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Address Line | 201 SECOND AVE
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City | COLLEGEVILLE
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State | PA
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Zip | 19426-3613
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Country | US
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Telephone | 610-454-7991
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DILIP N DUDHAT
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Credential | DMD
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Telephone | 215-237-6099
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | DS029728L
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License Number State | PA
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