Provider Demographics
NPI:1245706357
Name:DENTAL EXCELLENCE OF ROCKLEDGE, PC
Entity type:Organization
Organization Name:DENTAL EXCELLENCE OF ROCKLEDGE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DILIP
Authorized Official - Middle Name:
Authorized Official - Last Name:DUDHAT
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:215-237-6099
Mailing Address - Street 1:127 CARTERS MILL RD
Mailing Address - Street 2:
Mailing Address - City:FEASTERVILLE TREVOSE
Mailing Address - State:PA
Mailing Address - Zip Code:19053-2702
Mailing Address - Country:US
Mailing Address - Phone:215-828-2789
Mailing Address - Fax:
Practice Address - Street 1:2 S SYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:ROCKLEDGE
Practice Address - State:PA
Practice Address - Zip Code:19046-4417
Practice Address - Country:US
Practice Address - Phone:215-379-0900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-16
Last Update Date:2018-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental