Provider Demographics
NPI:1215051958
Name:TEWARI, DINESH S (DMD)
Entity type:Individual
Prefix:DR
First Name:DINESH
Middle Name:S
Last Name:TEWARI
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 1:500 PEMBROKE AVE
Mailing Address - Street 2:
Mailing Address - City:EAST LANSDOWNE
Mailing Address - State:PA
Mailing Address - Zip Code:19050-2518
Mailing Address - Country:US
Mailing Address - Phone:610-626-3028
Mailing Address - Fax:610-259-3557
Practice Address - Street 1:4244 FERNE BLVD
Practice Address - Street 2:
Practice Address - City:DREXEL HILL
Practice Address - State:PA
Practice Address - Zip Code:19026-3809
Practice Address - Country:US
Practice Address - Phone:610-259-6619
Practice Address - Fax:610-259-3557
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0355391223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0001XDental ProvidersDentistDental Public Health