# DENTIST OF PAOLI INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003529959
- **Authorized official:** RUTIKA AGRAWAL (PRESIDENT)
- **Authorized official phone:** (610) 889-8896

## Contact information

- **Practice address:** 63 CHESTNUT RD STE B, PAOLI, PA 19301-1535
- **Practice address phone:** (610) 889-8896
- **Practice address fax:** (610) 889-8897
- **Mailing address:** 63 CHESTNUT RD STE B, PAOLI, PA 19301-1535
- **Mailing address phone:** (610) 889-8896
- **Mailing address fax:** (610) 889-8897

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 01/05/2023
- **Last updated:** 01/05/2023