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General NPI Number Information
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NPI Number | 1912101395
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Entity Type | Organization
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Legal Business Name | ALETA L DETWILER DMD TERESA C STITELER DMD
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Dates
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Enumeration Date | 06/12/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 401 W BROAD ST
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City | QUAKERTOWN
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State | PA
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Zip | 18951-1264
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Country | US
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Telephone | 215-536-8111
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Fax | 215-536-1615
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Provider Business Mailing Address
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Address Line | 401 W BROAD ST
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City | QUAKERTOWN
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State | PA
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Zip | 18951-1264
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Country | US
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Telephone | 215-536-8111
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Fax | 215-536-1615
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. TERESA C STITELER
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Credential | D.M.D.
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Telephone | 215-536-8111
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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 | DN020629A
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DS024777L
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License Number State | PA
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