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General NPI Number Information
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NPI Number | 1912592288
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Entity Type | Organization
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Legal Business Name | DENTIST OF CHESTER SPRINGS, INC
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Dates
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Enumeration Date | 03/08/2021
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Last Update Date | 03/08/2021
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Provider Practice Location Address
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Address Line | 1024 POTTSTOWN PIKE
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City | CHESTER SPRINGS
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State | PA
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Zip | 19425-3511
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Country | US
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Telephone | 610-885-8856
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Fax |
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Provider Business Mailing Address
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Address Line | 1024 POTTSTOWN PIKE
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City | CHESTER SPRINGS
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State | PA
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Zip | 19425-3511
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Country | US
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Telephone | 610-885-8856
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/DENTIST
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Name | RUTIKA AGRAWAL
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Credential | MD
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Telephone | 201-286-8231
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223D0001X
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Taxonomy Name | Public Health Dentistry
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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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 | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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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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