Provider Demographics
NPI:1316501182
Name:PEARL FAMILY DENTISTRY PC
Entity type:Organization
Organization Name:PEARL FAMILY DENTISTRY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BHADRESH
Authorized Official - Middle Name:
Authorized Official - Last Name:MAKANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-384-1467
Mailing Address - Street 1:3494 LINCOLN HWY
Mailing Address - Street 2:
Mailing Address - City:THORNDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19372-1006
Mailing Address - Country:US
Mailing Address - Phone:610-384-1467
Mailing Address - Fax:
Practice Address - Street 1:3494 LINCOLN HWY
Practice Address - Street 2:
Practice Address - City:THORNDALE
Practice Address - State:PA
Practice Address - Zip Code:19372-1006
Practice Address - Country:US
Practice Address - Phone:610-384-1467
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-27
Last Update Date:2019-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty