Provider Demographics
NPI:1366787715
Name:BLUESTONE FAMILY AND COSMETIC DENTISTRY
Entity type:Organization
Organization Name:BLUESTONE FAMILY AND COSMETIC DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:C
Authorized Official - Last Name:BLUESTONE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:610-775-2226
Mailing Address - Street 1:1829 NEW HOLLAND RD
Mailing Address - Street 2:SUITE 7
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19607-2229
Mailing Address - Country:US
Mailing Address - Phone:610-775-2226
Mailing Address - Fax:610-775-3961
Practice Address - Street 1:1829 NEW HOLLAND RD
Practice Address - Street 2:SUITE 7
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19607-2229
Practice Address - Country:US
Practice Address - Phone:610-775-2226
Practice Address - Fax:610-775-3961
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-11
Last Update Date:2012-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS-023106-L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty