Marisiddaiah, Satish

Marisiddaiah, Satish is an sole proprietor health care provider with primary practice located at 653 Long Ln , Upper Darby PA 19082-5230. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Marisiddaiah, Satish can be contacted via phone (610) 623-5295.

Contact Information

Primary practice address
653 Long Ln Upper Darby PA 19082-5230
Fax: (610) 623-2979
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X DS027000-L Pennsylvania

Profile Details

NPI number 1205976370
LBN Legal business name Marisiddaiah, Satish
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 7th, 2007
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1205976370 NPPES
Pennsylvania MEDICAID 119271904
Pennsylvania Other 583471

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