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General NPI Number Information
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NPI Number | 1063709897
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Entity Type | Organization
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Legal Business Name | TRANSCEND DENTAL LLC
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Dates
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Enumeration Date | 06/30/2011
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Last Update Date | 06/30/2011
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Provider Practice Location Address
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Address Line | 70 BUCKWALTER RD SUITE 309
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City | ROYERSFORD
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State | PA
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Zip | 19468-1846
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Country | US
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Telephone | 610-616-3641
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Fax |
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Provider Business Mailing Address
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Address Line | 70 BUCKWALTER RD SUITE 309
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City | ROYERSFORD
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State | PA
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Zip | 19468-1846
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Country | US
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Telephone | 610-616-3641
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Fax |
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Authorized Official
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Title or Position | PERIODONTIST
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Name | SAMER KHOURY
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Credential | DDS MS
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Telephone | 610-616-3641
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | DS037420
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License Number State | PA
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