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NPI Code Detail

MEDICARE: NEW FALLS DENTAL GROUP, LLC

MEDICARE: NEW FALLS DENTAL GROUP, LLC
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
11223G0001XGeneral Practice DentistryDS037654PA

General Provider Information

NPI Number : 1689983165
Entity Type Code : Organization
Provider Name (Legal Business Name) : NEW FALLS DENTAL GROUP, LLC
Provider Business Mailing Address
First Line : 7419 NEW FALLS RD
Second Line :
City : LEVITTOWN
State : PA
Zip : 19055-1008
Country : US
Telephone Number : 215-945-5199
Fax Number :
Provider Business Practice Location Address
First Line : 7419 NEW FALLS RD
Second Line :
City : LEVITTOWN
State : PA
Zip : 19055-1008
Country : US
Telephone Number : 215-945-5199
Fax Number :
Authorized Official
Title or Position : DENTIST
Name : DR. KHURRAM SIDDIQUI
Credential : D.M.D.
Telephone Number : 215-945-5199
Provider Enumeration Date : 09/30/2010
Last Update Date : 09/30/2010

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Directions to “NEW FALLS DENTAL GROUP, LLC ” Practice Location

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