Provider Demographics
NPI:1184784860
Name:AMERICAN FAMILY DENTAL CARE P.C.
Entity type:Organization
Organization Name:AMERICAN FAMILY DENTAL CARE P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NIRANJAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SAVANI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:610-660-9510
Mailing Address - Street 1:301 CITY LINE AVE
Mailing Address - Street 2:SUITE# G-5
Mailing Address - City:BALA CYNWYD
Mailing Address - State:PA
Mailing Address - Zip Code:19004-1708
Mailing Address - Country:US
Mailing Address - Phone:610-660-9510
Mailing Address - Fax:610-660-9512
Practice Address - Street 1:301 CITY LINE AVE
Practice Address - Street 2:SUITE# G-5
Practice Address - City:BALA CYNWYD
Practice Address - State:PA
Practice Address - Zip Code:19004-1708
Practice Address - Country:US
Practice Address - Phone:610-660-9510
Practice Address - Fax:610-660-9512
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMERICAN FAMILY DENTAL CARE P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-12-11
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS-029756-L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001841370Medicaid
PA001841370Medicare ID - Type Unspecified