Provider Demographics
NPI:1902177173
Name:LEVITTOWN FAMILY DENTAL ASSOCIATES, LLC
Entity Type:Organization
Organization Name:LEVITTOWN FAMILY DENTAL ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:ABRAMS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:215-945-5588
Mailing Address - Street 1:359 INDIAN CREEK DR
Mailing Address - Street 2:
Mailing Address - City:LEVITTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19057-2712
Mailing Address - Country:US
Mailing Address - Phone:215-945-5588
Mailing Address - Fax:215-945-1308
Practice Address - Street 1:359 INDIAN CREEK DR
Practice Address - Street 2:
Practice Address - City:LEVITTOWN
Practice Address - State:PA
Practice Address - Zip Code:19057-2712
Practice Address - Country:US
Practice Address - Phone:215-945-5588
Practice Address - Fax:215-945-1308
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-19
Last Update Date:2012-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS036382261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental