Provider Demographics
NPI:1780356618
Name:RACHEL E WALSH DMD PC
Entity type:Organization
Organization Name:RACHEL E WALSH DMD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:WALSH
Authorized Official - Last Name:REILLY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:484-744-3403
Mailing Address - Street 1:772 S FRONT ST APT 100B
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19147-3501
Mailing Address - Country:US
Mailing Address - Phone:484-744-3403
Mailing Address - Fax:
Practice Address - Street 1:2416 W DARBY RD
Practice Address - Street 2:
Practice Address - City:HAVERTOWN
Practice Address - State:PA
Practice Address - Zip Code:19083-1423
Practice Address - Country:US
Practice Address - Phone:610-446-4210
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-29
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental