Healthcare Provider Details

I. General information

NPI: 1336263771
Provider Name (Legal Business Name): RONALD B GROSS & ASSOCIATES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

531 N CHARLOTTE ST
POTTSTOWN PA
19464-4602
US

IV. Provider business mailing address

531 N CHARLOTTE ST
POTTSTOWN PA
19464-4602
US

V. Phone/Fax

Practice location:
  • Phone: 610-326-9797
  • Fax:
Mailing address:
  • Phone: 610-326-9797
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License NumberDS018086L
License Number StatePA

VIII. Authorized Official

Name: DR. JOEL R FROMER
Title or Position: PRESIDENT
Credential:
Phone: 610-326-9797