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NPI Code Detail

MEDICARE: DENTEX DENTAL GROUP

MEDICARE: DENTEX DENTAL GROUP
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 Dentistry

General Provider Information

NPI Number : 1770861130
Entity Type Code : Organization
Provider Name (Legal Business Name) : DENTEX DENTAL GROUP
Provider Business Mailing Address
First Line : 1701 E MOYAMENSING AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19148-1931
Country : US
Telephone Number : 215-462-4034
Fax Number :
Provider Business Practice Location Address
First Line : 1701 E MOYAMENSING AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19148-1931
Country : US
Telephone Number : 215-462-4034
Fax Number :
Authorized Official
Title or Position : OFFICE MANAGER
Name : DR. JOEL EICHEN
Credential : DDS
Telephone Number : 215-462-4047
Provider Enumeration Date : 08/02/2011
Last Update Date : 08/02/2011

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Directions to “DENTEX DENTAL GROUP ” Practice Location

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