Healthcare Provider Details

I. General information

NPI: 1831363308
Provider Name (Legal Business Name): BUX-MONT ORTHODONTIC ASSOCIATES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2008
Last Update Date: 06/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

760 NEWTOWN YARDLEY RD SUITE 122
NEWTOWN PA
18940
US

IV. Provider business mailing address

278 HUNSBERGER LN
HARLEYSVILLE PA
19438-1812
US

V. Phone/Fax

Practice location:
  • Phone: 215-860-7272
  • Fax:
Mailing address:
  • Phone: 215-256-6850
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License NumberDS025463L
License Number StatePA

VIII. Authorized Official

Name: ROSS A ZIEGLER
Title or Position: OWNER
Credential: DMD
Phone: 215-860-7272