MEDICARE: ADVANCED FAMILY DENTISTRY, P.C.

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
1	122300000X	Dentist	DS-029417L	PA

General Provider Information

NPI Number	:	1609149889
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED FAMILY DENTISTRY, P.C.

Provider Business Mailing Address
First Line	:	401 COMMERCE DR
Second Line	:	SUITE 108
City	:	FORT WASHINGTON
State	:	PA
Zip	:	19034-2714
Country	:	US
Telephone Number	:	267-460-4254
Fax Number	:	215-646-6369

Provider Business Practice Location Address
First Line	:	2630 W CHELTENHAM AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19150-1311
Country	:	US
Telephone Number	:	215-924-3747
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	BHASKAR SAVANI
Credential	:	DMD
Telephone Number	:	267-460-4254

Provider Enumeration Date	:	02/17/2012
Last Update Date	:	02/17/2012

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