Healthcare Provider Details

I. General information

NPI: 1588741409
Provider Name (Legal Business Name): BETH M. SKOVRON DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 08/08/2023
Certification Date: 08/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

595 BETHLEHEM PIKE SUITE 302
MONTGOMERYVILLE PA
18936-9710
US

IV. Provider business mailing address

595 BETHLEHEM PIKE SUITE 302
MONTGOMERYVILLE PA
18936-9710
US

V. Phone/Fax

Practice location:
  • Phone: 215-792-2227
  • Fax: 215-822-3861
Mailing address:
  • Phone: 215-792-2227
  • Fax: 215-822-3861

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number029245L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: