Provider Demographics
NPI:1871337592
Name:MINTED DENTAL PC
Entity type:Organization
Organization Name:MINTED DENTAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAGINI
Authorized Official - Middle Name:
Authorized Official - Last Name:SINGLA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:215-779-3381
Mailing Address - Street 1:124 LADBROKE DR
Mailing Address - Street 2:
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341-2454
Mailing Address - Country:US
Mailing Address - Phone:215-779-3381
Mailing Address - Fax:
Practice Address - Street 1:2050 W CHESTER PIKE STE 4
Practice Address - Street 2:
Practice Address - City:HAVERTOWN
Practice Address - State:PA
Practice Address - Zip Code:19083-2742
Practice Address - Country:US
Practice Address - Phone:610-789-0178
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-19
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty