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General NPI Number Information
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NPI Number | 1255485843
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Entity Type | Organization
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Legal Business Name | FLORAL VALE PERIODONTICS & IMPLANTS, P.C.
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Dates
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Enumeration Date | 01/22/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 712 FLORAL VALE BLVD
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City | YARDLEY
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State | PA
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Zip | 19067-5529
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Country | US
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Telephone | 215-860-4700
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Fax | 215-860-3707
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Provider Business Mailing Address
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Address Line | 712 FLORAL VALE BLVD
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City | YARDLEY
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State | PA
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Zip | 19067-5529
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Country | US
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Telephone | 215-860-4700
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Fax | 215-860-3707
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Authorized Official
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Title or Position | OWNER
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Name | DR. EDWARD A MARCUS
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Credential | D.D.S.
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Telephone | 215-860-4700
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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 | DS018304L
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License Number State | PA
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