Provider Demographics
NPI:1760641880
Name:ASSOCIATES IN ENDODONTICS
Entity type:Organization
Organization Name:ASSOCIATES IN ENDODONTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HEIDI
Authorized Official - Middle Name:A
Authorized Official - Last Name:RAY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:724-461-7161
Mailing Address - Street 1:6530 RT 22 SALEM PLACE
Mailing Address - Street 2:SUITE 305
Mailing Address - City:DELMONT
Mailing Address - State:PA
Mailing Address - Zip Code:15626
Mailing Address - Country:US
Mailing Address - Phone:724-461-7191
Mailing Address - Fax:724-461-7597
Practice Address - Street 1:6530 RT 22 SALEM PLACE
Practice Address - Street 2:SUITE 305
Practice Address - City:DELMONT
Practice Address - State:PA
Practice Address - Zip Code:15626
Practice Address - Country:US
Practice Address - Phone:724-461-7191
Practice Address - Fax:724-461-7597
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PRECISION ENDODONTICS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-06-04
Last Update Date:2017-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS027224-L1223E0200X
PA1223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty