Healthcare Provider Details

I. General information

NPI: 1376895474
Provider Name (Legal Business Name): ADVANCED ORAL SURGERY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2012
Last Update Date: 10/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 COMMERCE DR SUITE 108
FT WASHINGTON PA
19034-2714
US

IV. Provider business mailing address

401 COMMERCE DR SUITE 108
FT WASHINGTON PA
19034-2714
US

V. Phone/Fax

Practice location:
  • Phone: 267-460-4254
  • Fax: 215-646-6166
Mailing address:
  • Phone: 267-460-4254
  • Fax: 215-646-6166

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberDS029417
License Number StatePA

VIII. Authorized Official

Name: DR. BHASKAR M. SAVANI
Title or Position: OWNER
Credential: D.M.D.
Phone: 267-460-4254