Healthcare Provider Details

I. General information

NPI: 1437206455
Provider Name (Legal Business Name): DRS. MARCY AND NEWELL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2217 MOUNT CARMEL AVE
GLENSIDE PA
19038-4709
US

IV. Provider business mailing address

2217 MOUNT CARMEL AVE
GLENSIDE PA
19038-4709
US

V. Phone/Fax

Practice location:
  • Phone: 215-884-1595
  • Fax: 215-884-3947
Mailing address:
  • Phone: 215-884-1595
  • Fax: 215-884-3947

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDS018612L
License Number StatePA

VIII. Authorized Official

Name: DR. HARRY MARCY
Title or Position: PARTNER
Credential: DMD
Phone: 215-884-1595