# BOOTWAY DENTAL LLC

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

## Provider details

- **NPI number:** 1912574484
- **Authorized official:** BENJAMIN E TUINEI (CREDENTIALING MANAGER)
- **Authorized official phone:** (602) 750-6897

## Contact information

- **Practice address:** 313 W BOOT RD, WEST CHESTER, PA 19380-1109
- **Practice address phone:** (610) 701-0102
- **Mailing address:** 313 W BOOT RD, WEST CHESTER, PA 19380-1109
- **Mailing address phone:** (610) 701-0102

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223D0001X | Public Health Dentistry | — | NULL | Yes |
| 1223D0001X | Public Health Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 06/04/2021
- **Last updated:** 06/04/2021