Provider Demographics
NPI:1194153080
Name:AMERICAN DENTAL ASSOCIATES PC
Entity type:Organization
Organization Name:AMERICAN DENTAL ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DILIP
Authorized Official - Middle Name:
Authorized Official - Last Name:DUDHAT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-331-1330
Mailing Address - Street 1:3428 RHAWN ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19136-2610
Mailing Address - Country:US
Mailing Address - Phone:215-331-1330
Mailing Address - Fax:215-333-3432
Practice Address - Street 1:3428 RHAWN ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19136-2610
Practice Address - Country:US
Practice Address - Phone:215-331-1330
Practice Address - Fax:215-333-3432
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-31
Last Update Date:2013-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental