Healthcare Provider Details

I. General information

NPI: 1073195426
Provider Name (Legal Business Name): SBW DENTAL ASSOCIATES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2021
Last Update Date: 04/26/2021
Certification Date: 04/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

170 N HENDERSON RD STE 304
KING OF PRUSSIA PA
19406-2155
US

IV. Provider business mailing address

102 NURSERY DR
PLYMOUTH MEETING PA
19462-2835
US

V. Phone/Fax

Practice location:
  • Phone: 610-278-0009
  • Fax: 610-553-6309
Mailing address:
  • Phone: 610-278-0009
  • Fax: 610-553-6309

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. SAMANTHA BABKA WONG
Title or Position: PRESIDENT/OWNER
Credential: DMD
Phone: 610-278-0009