Provider Demographics
NPI:1124033774
Name:DUDHAT, DILIP N (DMD)
Entity type:Individual
Prefix:
First Name:DILIP
Middle Name:N
Last Name:DUDHAT
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2406 N BROAD ST
Mailing Address - Street 2:
Mailing Address - City:COLMAR
Mailing Address - State:PA
Mailing Address - Zip Code:18915-9701
Mailing Address - Country:US
Mailing Address - Phone:215-997-2300
Mailing Address - Fax:215-997-0227
Practice Address - Street 1:2406 N BROAD ST
Practice Address - Street 2:
Practice Address - City:COLMAR
Practice Address - State:PA
Practice Address - Zip Code:18915-9701
Practice Address - Country:US
Practice Address - Phone:215-997-2300
Practice Address - Fax:215-997-0227
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-30
Last Update Date:2010-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA0297281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice