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General NPI Number Information
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NPI Number | 1093621500
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Entity Type | Organization
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Legal Business Name | AUDUBON DENTAL ASSOCIATES, LLC
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Dates
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Enumeration Date | 08/24/2026
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Last Update Date | 08/24/2026
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Provider Practice Location Address
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Address Line | 2642 AUDUBON RD
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City | AUDUBON
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State | PA
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Zip | 19403-2419
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Country | US
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Telephone | 610-666-7590
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Fax |
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Provider Business Mailing Address
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Address Line | 2642 AUDUBON RD
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City | AUDUBON
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State | PA
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Zip | 19403-2419
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DR. MIRA DELLA CROCE
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Credential | DMD, FAGD
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Telephone | 215-200-7883
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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