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General NPI Number Information
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NPI Number | 1275220865
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Entity Type | Organization
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Legal Business Name | BUXMONT PERIODONTICS AND DENTAL IMPLANTS PLLC
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Dates
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Enumeration Date | 04/24/2023
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Last Update Date | 04/24/2023
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Provider Practice Location Address
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Address Line | 179 N MAIN ST UNIT 1
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City | DUBLIN
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State | PA
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Zip | 18917-2107
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Country | US
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Telephone | 267-873-4044
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Fax | 267-873-4077
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Provider Business Mailing Address
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Address Line | 391 ESSEX CT
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City | PERKASIE
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State | PA
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Zip | 18944-1297
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Country | US
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Telephone | 267-307-2358
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Fax | 267-873-4077
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Authorized Official
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Title or Position | OWNER/ PERIODONTIST
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Name | DR. JOSEPH LEONARD MUSTAZZA
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Credential | DMD MS
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Telephone | 267-307-2358
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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 |
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License Number State |
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