Healthcare Provider Details

I. General information

NPI: 1932254877
Provider Name (Legal Business Name): ANDREW JOSEPH MRAMOR D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 12/03/2021
Certification Date: 12/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 WHITE HORSE RD
VOORHEES NJ
08043-4406
US

IV. Provider business mailing address

1001 N 2ND ST APT 351
PHILADELPHIA PA
19123-1603
US

V. Phone/Fax

Practice location:
  • Phone: 856-545-3295
  • Fax:
Mailing address:
  • Phone: 267-357-0811
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDS-036023
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: