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General NPI Number Information
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NPI Number | 1073195426
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Entity Type | Organization
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Legal Business Name | SBW DENTAL ASSOCIATES, P.C.
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Dates
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Enumeration Date | 04/26/2021
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Last Update Date | 04/26/2021
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Provider Practice Location Address
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Address Line | 170 N HENDERSON RD STE 304
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City | KING OF PRUSSIA
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State | PA
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Zip | 19406-2155
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Country | US
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Telephone | 610-278-0009
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Fax | 610-553-6309
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Provider Business Mailing Address
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Address Line | 102 NURSERY DR
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City | PLYMOUTH MEETING
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State | PA
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Zip | 19462-2835
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Country | US
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Telephone | 610-278-0009
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Fax | 610-553-6309
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. SAMANTHA BABKA WONG
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Credential | DMD
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Telephone | 610-278-0009
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223D0001X
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Taxonomy Name | Public Health Dentistry
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License Number |
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License Number State |
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