MEDICARE: DR. JOSEPH WILLIAM CASEY D.D.S.

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	DI0238000	NJ
2	1223G0001X	General Practice Dentistry	DS021966L	PA

General Provider Information

NPI Number	:	1619024460
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH WILLIAM CASEY D.D.S.

Provider Business Mailing Address
First Line	:	4414 MARVINE AVE
Second Line	:
City	:	DREXEL HILL
State	:	PA
Zip	:	19026-4041
Country	:	US
Telephone Number	:	610-446-9165
Fax Number	:

Provider Business Practice Location Address
First Line	:	1100 TOWN SQUARE RD
Second Line	:
City	:	POTTSTOWN
State	:	PA
Zip	:	19465-1017
Country	:	US
Telephone Number	:	610-323-6350
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/04/2007
Last Update Date	:	02/15/2013

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