Healthcare Provider Details

I. General information

NPI: 1912117656
Provider Name (Legal Business Name): ANNE ELIZABETH O'DAY DMD,MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3503 YORK ROAD
FURLONG PA
18925
US

IV. Provider business mailing address

84 WOODCREST LANE
DOYLESTOWN PA
18901
US

V. Phone/Fax

Practice location:
  • Phone: 215-794-5002
  • Fax:
Mailing address:
  • Phone: 215-340-0174
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License NumberDS029807-L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: