MEDICARE: DR. DENIS ANDREW QUAGLIARIELLO D.M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	DS029408L	PA

General Provider Information

NPI Number	:	1407818321
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DENIS ANDREW QUAGLIARIELLO D.M.D.

Provider Business Mailing Address
First Line	:	2309 POPLAR RD
Second Line	:
City	:	HAVERTOWN
State	:	PA
Zip	:	19083-1643
Country	:	US
Telephone Number	:	610-446-8364
Fax Number	:

Provider Business Practice Location Address
First Line	:	1502 W CHESTER PIKE
Second Line	:	SUITE 20
City	:	WEST CHESTER
State	:	PA
Zip	:	19382-7705
Country	:	US
Telephone Number	:	610-692-3312
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/05/2006
Last Update Date	:	09/13/2007

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