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General NPI Number Information
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NPI Number | 1336862176
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Entity Type | Organization
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Legal Business Name | DENTAL IMPLANT STUDIO OF MONTGOMERY PC
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Dates
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Enumeration Date | 09/26/2022
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Last Update Date | 09/26/2022
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Provider Practice Location Address
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Address Line | 2874 RIDGE PIKE
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City | EAGLEVILLE
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State | PA
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Zip | 19403-1590
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Country | US
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Telephone | 484-963-4766
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Fax |
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Provider Business Mailing Address
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Address Line | 2489 WELLINGTON WAY
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City | HATFIELD
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State | PA
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Zip | 19440-1489
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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 | OWNER
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Name | NIL DHANANI
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Credential |
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Telephone | 484-963-4766
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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