Provider Demographics
NPI:1427264720
Name:CHILDREN'S DENTISTRY OF TRAPPE
Entity type:Organization
Organization Name:CHILDREN'S DENTISTRY OF TRAPPE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:HANS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:610-409-1940
Mailing Address - Street 1:515 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:COLLEGEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19426-1923
Mailing Address - Country:US
Mailing Address - Phone:610-409-1940
Mailing Address - Fax:610-409-1941
Practice Address - Street 1:515 W MAIN ST
Practice Address - Street 2:
Practice Address - City:COLLEGEVILLE
Practice Address - State:PA
Practice Address - Zip Code:19426-1923
Practice Address - Country:US
Practice Address - Phone:610-409-1940
Practice Address - Fax:610-409-1941
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS029284L1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty