Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | DS018005L | PA |
NPI | 1235354853 |
---|---|
Provider Name | Dr. Ernest J. Dellheim |
First Address | Narberth, PA 19072-2031 |
Second Address | Narberth, PA 19072-2031 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2007 |
Last Update Date | 31/01/2008 |