Provider Demographics
NPI:1487080172
Name:HARLEYSVILLE FAMILY DENTISTRY
Entity type:Organization
Organization Name:HARLEYSVILLE FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SULZBACH
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:215-362-8166
Mailing Address - Street 1:456 SCHOOL LANE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:HARLEYSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19438
Mailing Address - Country:US
Mailing Address - Phone:215-362-8166
Mailing Address - Fax:
Practice Address - Street 1:456 SCHOOL LN
Practice Address - Street 2:SUITE 105
Practice Address - City:HARLEYSVILLE
Practice Address - State:PA
Practice Address - Zip Code:19438-1703
Practice Address - Country:US
Practice Address - Phone:215-362-8166
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-25
Last Update Date:2013-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty