Provider Demographics
NPI:1962741736
Name:NEW GARDEN FAMILY DENTISTRY
Entity type:Organization
Organization Name:NEW GARDEN FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:AFASH
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:610-268-2040
Mailing Address - Street 1:385 STARR RD
Mailing Address - Street 2:SUITE # 202
Mailing Address - City:LANDENBERG
Mailing Address - State:PA
Mailing Address - Zip Code:19350-9221
Mailing Address - Country:US
Mailing Address - Phone:610-268-2040
Mailing Address - Fax:
Practice Address - Street 1:385 STARR RD
Practice Address - Street 2:SUITE # 202
Practice Address - City:LANDENBERG
Practice Address - State:PA
Practice Address - Zip Code:19350-9221
Practice Address - Country:US
Practice Address - Phone:610-268-2040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-13
Last Update Date:2013-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS037157261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental