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NPI Code Detail

MEDICARE: FAIRLESS HILLS DENTAL CENTER INC.

MEDICARE: FAIRLESS HILLS DENTAL CENTER INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist13072MD
2122300000XDentistDS027276LPA

General Provider Information

NPI Number : 1083712517
Entity Type Code : Organization
Provider Name (Legal Business Name) : FAIRLESS HILLS DENTAL CENTER INC.
Provider Business Mailing Address
First Line : 532 S OXFORD VALLEY RD
Second Line :
City : FAIRLESS HILLS
State : PA
Zip : 19030-2615
Country : US
Telephone Number : 215-946-3655
Fax Number : 215-946-1041
Provider Business Practice Location Address
First Line : 532 S OXFORD VALLEY RD
Second Line :
City : FAIRLESS HILLS
State : PA
Zip : 19030-2615
Country : US
Telephone Number : 215-946-3655
Fax Number : 215-946-1041
Authorized Official
Title or Position : INSURANCE MANAGER
Name : MRS. LISA A RADER
Credential :
Telephone Number : 215-946-3655
Provider Enumeration Date : 09/20/2006
Last Update Date : 08/15/2008

Similar Medicare Providers

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Practice Location Address:
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1427347723 — DR. BENJAMIN NACHUM PHARMD
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1184905317 — LISA RADER DMD
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1730432287 — INFINITY DENTAL MANAGEMENT LLC
Practice Location Address:
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Practice Fax: 215-946-1041

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