Provider Demographics
NPI:1538235593
Name:JANE ANN GRIFFITH & ASSOC
Entity type:Organization
Organization Name:JANE ANN GRIFFITH & ASSOC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JANE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:GRIFFITH
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:215-672-2244
Mailing Address - Street 1:41 BUBERRY AVE SUITE 2
Mailing Address - Street 2:
Mailing Address - City:HATBORO
Mailing Address - State:PA
Mailing Address - Zip Code:19040
Mailing Address - Country:US
Mailing Address - Phone:215-972-2244
Mailing Address - Fax:215-675-9730
Practice Address - Street 1:41 BUBERRY AVE SUITE 2
Practice Address - Street 2:
Practice Address - City:HATBORO
Practice Address - State:PA
Practice Address - Zip Code:19040
Practice Address - Country:US
Practice Address - Phone:215-972-2244
Practice Address - Fax:215-675-9730
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2011-08-30
Deactivation Date:2008-04-30
Deactivation Code:
Reactivation Date:2011-08-30
Provider Licenses
StateLicense IDTaxonomies
PADS020061L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GR108576OtherUNITED CONCORDIA