Provider Demographics
NPI:1194542811
Name:TEMPLE DENTAL ARTS LLC
Entity type:Organization
Organization Name:TEMPLE DENTAL ARTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:HITESHKUMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:NADA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:267-632-4584
Mailing Address - Street 1:4729 KUTZTOWN RD
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:PA
Mailing Address - Zip Code:19560-1549
Mailing Address - Country:US
Mailing Address - Phone:267-632-4584
Mailing Address - Fax:
Practice Address - Street 1:4729 KUTZTOWN RD
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:PA
Practice Address - Zip Code:19560-1549
Practice Address - Country:US
Practice Address - Phone:267-632-4584
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-24
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental