Provider Demographics
NPI:1679234314
Name:FAMILY DENTISTRY OF BENSALEM
Entity type:Organization
Organization Name:FAMILY DENTISTRY OF BENSALEM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:
Authorized Official - Last Name:TUNO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-412-7973
Mailing Address - Street 1:4201 NESHAMINY BLVD
Mailing Address - Street 2:
Mailing Address - City:BENSALEM
Mailing Address - State:PA
Mailing Address - Zip Code:19020-1609
Mailing Address - Country:US
Mailing Address - Phone:215-396-9080
Mailing Address - Fax:
Practice Address - Street 1:4201 NESHAMINY BLVD
Practice Address - Street 2:
Practice Address - City:BENSALEM
Practice Address - State:PA
Practice Address - Zip Code:19020-1609
Practice Address - Country:US
Practice Address - Phone:215-396-9080
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-05
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1023088408Other1023088408