Provider Demographics
NPI:1851550826
Name:DELLIGATTI & MILEWSKI ORTHODONTIC GROUP, P.C.
Entity type:Organization
Organization Name:DELLIGATTI & MILEWSKI ORTHODONTIC GROUP, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:FOX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-214-5994
Mailing Address - Street 1:7 E SKIPPACK PIKE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:AMBLER
Mailing Address - State:PA
Mailing Address - Zip Code:19002-5310
Mailing Address - Country:US
Mailing Address - Phone:215-214-5994
Mailing Address - Fax:215-214-5994
Practice Address - Street 1:6404 ROOSEVELT BLVD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19149-2943
Practice Address - Country:US
Practice Address - Phone:215-214-5994
Practice Address - Fax:215-214-5994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-05
Last Update Date:2015-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS031283L1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty