Organization
CHADDS FORD DENTAL VILLAGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SIAD HUSSIEN MOHAMED-ALI DDS (OWNER)
(610) 459-4915
Entity
Organization
Contact information
Practice address
98 ROUTE 202 AT PA DE LINE, CHADDS FORD, PA 19317
(610) 459-4915
(610) 459-9752
Mailing address
98 ROUTE 202 AT PA DE LINE, CHADDS FORD, PA 19317
(610) 459-4915
(610) 459-9752
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS020611L
PA
Other
Enumeration date
11/30/2006
Last updated
08/22/2020
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