Provider Demographics
NPI:1962730689
Name:DENTAL HEALTH ASSOCIATES, LTD.
Entity type:Organization
Organization Name:DENTAL HEALTH ASSOCIATES, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:ROEDER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:610-647-7272
Mailing Address - Street 1:45 DARBY RD
Mailing Address - Street 2:
Mailing Address - City:PAOLI
Mailing Address - State:PA
Mailing Address - Zip Code:19301-1475
Mailing Address - Country:US
Mailing Address - Phone:610-647-7272
Mailing Address - Fax:610-647-7278
Practice Address - Street 1:45 DARBY RD
Practice Address - Street 2:
Practice Address - City:PAOLI
Practice Address - State:PA
Practice Address - Zip Code:19301-1475
Practice Address - Country:US
Practice Address - Phone:610-647-7272
Practice Address - Fax:610-647-7278
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-19
Last Update Date:2009-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS030929L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty