# LOUIS F VIDA DDSPC

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

## Provider details

- **NPI number:** 1003975319
- **Authorized official:** DR. LOUIS F VIDA DDS PC (OWNER)
- **Authorized official phone:** (215) 348-1192

## Contact information

- **Practice address:** 407 N MAIN ST, DOYLESTOWN, PA 18901-3403
- **Practice address phone:** (215) 348-1192
- **Practice address fax:** (215) 348-2580
- **Mailing address:** 407 N MAIN ST, DOYLESTOWN, PA 18901-3403
- **Mailing address phone:** (215) 348-1192
- **Mailing address fax:** (215) 348-2580

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | DS19060L | PA | Yes |

## Other

- **Enumeration date:** 12/06/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 157954 | BLUE SHIELD | PA |