Healthcare Provider Details

I. General information

NPI: 1205948924
Provider Name (Legal Business Name): ANTHONLY H MAPES OMD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 MAIN STREET
CHALFONT PA
19814-2912
US

IV. Provider business mailing address

24 MAIN STREET
CHALFONT PA
19814-2912
US

V. Phone/Fax

Practice location:
  • Phone: 215-822-3569
  • Fax: 215-822-0387
Mailing address:
  • Phone: 215-822-3569
  • Fax: 215-822-0387

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number017844L
License Number StatePA

VIII. Authorized Official

Name: DR. ANTHONY H MAPES
Title or Position: ORTHODONTIST
Credential: DMP
Phone: 215-822-3569