Healthcare Provider Details

I. General information

NPI: 1710924071
Provider Name (Legal Business Name): LEHIGH ORAL & MAXILLOFACIAL SURGERY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 01/26/2023
Certification Date: 01/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1251 S CEDAR CREST BLVD
ALLENTOWN PA
18103-6205
US

IV. Provider business mailing address

1251 S CEDAR CREST BLVD
ALLENTOWN PA
18103-6205
US

V. Phone/Fax

Practice location:
  • Phone: 610-435-6161
  • Fax: 610-435-2902
Mailing address:
  • Phone: 610-435-6161
  • Fax: 610-435-2902

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number StatePA

VIII. Authorized Official

Name: DR. DAVID M BENDER
Title or Position: PRESIDENT
Credential: DMD
Phone: 610-435-6161