Provider Demographics
NPI:1679594063
Name:MAGIDA, EDWARD ALAN (DMD)
Entity type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:ALAN
Last Name:MAGIDA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:607 GLEN MEADOW RD
Mailing Address - Street 2:
Mailing Address - City:RICHBORO
Mailing Address - State:PA
Mailing Address - Zip Code:18954-1669
Mailing Address - Country:US
Mailing Address - Phone:215-579-0829
Mailing Address - Fax:
Practice Address - Street 1:7 CAMBRIDGE LN
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-3326
Practice Address - Country:US
Practice Address - Phone:215-968-7787
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS-023086-L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist