Organization
LOUIS F VIDA DDSPC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LOUIS F VIDA DDS PC (OWNER)
(215) 348-1192
Entity
Organization
Contact information
Practice address
407 N MAIN ST, DOYLESTOWN, PA 18901-3403
(215) 348-1192
(215) 348-2580
Mailing address
407 N MAIN ST, DOYLESTOWN, PA 18901-3403
(215) 348-1192
(215) 348-2580
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS19060L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
157954
BLUE SHIELD
PA
Enumeration date
12/06/2006
Last updated
08/22/2020
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