Provider Demographics
NPI:1538760087
Name:RG DENTAL GROUP OF RICHBORO, LLC
Entity type:Organization
Organization Name:RG DENTAL GROUP OF RICHBORO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO, OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALEXANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:GATSCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-635-5737
Mailing Address - Street 1:56 NEWTOWN RICHBORO RD.
Mailing Address - Street 2:SUITE 1
Mailing Address - City:RICHBORO
Mailing Address - State:PA
Mailing Address - Zip Code:18954
Mailing Address - Country:US
Mailing Address - Phone:215-355-6406
Mailing Address - Fax:215-357-5718
Practice Address - Street 1:56 NEWTOWN RICHBORO RD.
Practice Address - Street 2:SUITE 1
Practice Address - City:RICHBORO
Practice Address - State:PA
Practice Address - Zip Code:18954
Practice Address - Country:US
Practice Address - Phone:215-355-6406
Practice Address - Fax:215-357-5718
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-02
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty