Provider Demographics
NPI:1447370721
Name:FIRST DENTAL OF WEST CHESTER, INC.
Entity type:Organization
Organization Name:FIRST DENTAL OF WEST CHESTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST CORPORATE SECRETARY TREASUR
Authorized Official - Prefix:DR
Authorized Official - First Name:CARL
Authorized Official - Middle Name:H
Authorized Official - Last Name:VOSS
Authorized Official - Suffix:JR
Authorized Official - Credentials:DMD
Authorized Official - Phone:610-692-3953
Mailing Address - Street 1:227 WEST MINER STREET
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19382-2924
Mailing Address - Country:US
Mailing Address - Phone:610-692-3953
Mailing Address - Fax:
Practice Address - Street 1:227 WEST MINER STREET
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19382-2924
Practice Address - Country:US
Practice Address - Phone:610-692-3953
Practice Address - Fax:610-692-7431
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-30
Last Update Date:2014-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS017243L122300000X
PADS019010L122300000X
PADS029264L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty