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General NPI Number Information
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NPI Number | 1942223383
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Entity Type | Organization
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Legal Business Name | THORNDALE PEDIATRIC DENTISTRY
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Dates
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Enumeration Date | 07/26/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3915 W LINCOLN HWY
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City | DOWNINGTOWN
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State | PA
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Zip | 19335-5502
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Country | US
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Telephone | 610-269-1900
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Fax | 610-269-2725
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Provider Business Mailing Address
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Address Line | 3915 W LINCOLN HWY
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City | DOWNINGTOWN
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State | PA
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Zip | 19335-5502
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Country | US
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Telephone | 610-269-1900
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Fax | 610-269-2725
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ERIC FELIX
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Credential | DMD
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Telephone | 610-269-1900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | DS030525-L
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License Number State | PA
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