Provider Demographics
NPI:1164831541
Name:BENSALEM PEDIATRIC DENTISTRY PC
Entity type:Organization
Organization Name:BENSALEM PEDIATRIC DENTISTRY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:FELIX
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:610-470-8686
Mailing Address - Street 1:2217 BALTIMORE PIKE
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:19363-4013
Mailing Address - Country:US
Mailing Address - Phone:610-492-7899
Mailing Address - Fax:610-467-1717
Practice Address - Street 1:3101 BRISTOL RD
Practice Address - Street 2:SUITE 1
Practice Address - City:BENSALEM
Practice Address - State:PA
Practice Address - Zip Code:19020-2168
Practice Address - Country:US
Practice Address - Phone:610-470-8686
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-11
Last Update Date:2014-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS030525L1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty