Provider Demographics
NPI:1912291576
Name:WHITEMARSH DENTAL CARE,INC
Entity type:Organization
Organization Name:WHITEMARSH DENTAL CARE,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:JYOTI
Authorized Official - Middle Name:
Authorized Official - Last Name:DESHMANE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:610-825-7444
Mailing Address - Street 1:9 CAMELOT WAY
Mailing Address - Street 2:
Mailing Address - City:HARLEYSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19438-2910
Mailing Address - Country:US
Mailing Address - Phone:610-825-7444
Mailing Address - Fax:610-825-6002
Practice Address - Street 1:400R GERMANTOWN PIKE
Practice Address - Street 2:
Practice Address - City:LAFAYETTE HILL
Practice Address - State:PA
Practice Address - Zip Code:19444-1804
Practice Address - Country:US
Practice Address - Phone:610-825-7444
Practice Address - Fax:610-825-6002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-01
Last Update Date:2011-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty