Provider Demographics
NPI:1134537418
Name:EASY DENTAL LLC
Entity type:Organization
Organization Name:EASY DENTAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:PARASCHINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-335-2181
Mailing Address - Street 1:5616 GERMANTOWN AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19144-2228
Mailing Address - Country:US
Mailing Address - Phone:267-335-2181
Mailing Address - Fax:267-335-2188
Practice Address - Street 1:5616 GERMANTOWN AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19144-2228
Practice Address - Country:US
Practice Address - Phone:267-335-2181
Practice Address - Fax:267-335-2188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-30
Last Update Date:2014-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA6363941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty