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General NPI Number Information
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NPI Number | 1023626850
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Entity Type | Organization
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Legal Business Name | ORCHARD OF SMILES ORTHODONTICS LLC
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Dates
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Enumeration Date | 07/17/2020
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Last Update Date | 07/17/2020
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Provider Practice Location Address
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Address Line | 1629 BRIDGETOWN PIKE
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City | FEASTERVILLE TREVOSE
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State | PA
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Zip | 19053-4218
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Country | US
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Telephone | 267-991-9690
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Fax |
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Provider Business Mailing Address
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Address Line | 1629 BRIDGETOWN PIKE
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City | FEASTERVILLE TREVOSE
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State | PA
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Zip | 19053-4218
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Country | US
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Telephone | 267-991-9690
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Fax |
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Authorized Official
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Title or Position | ORTHODONTIST
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Name | ANNA MORRISON
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Credential | DMD, MS
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Telephone | 215-715-2545
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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