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General NPI Number Information
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NPI Number | 1396391660
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Entity Type | Organization
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Legal Business Name | A2Z ORAL SURGERY LLC
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Dates
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Enumeration Date | 08/13/2019
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Last Update Date | 08/13/2019
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Provider Practice Location Address
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Address Line | 201 S EASTON RD
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City | GLENSIDE
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State | PA
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Zip | 19038-4428
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Country | US
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Telephone | 215-576-1155
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Fax | 215-886-3821
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Provider Business Mailing Address
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Address Line | 201 S EASTON RD
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City | GLENSIDE
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State | PA
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Zip | 19038-4428
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Country | US
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Telephone | 215-576-1155
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Fax | 215-886-3821
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Authorized Official
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Title or Position | OWNER
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Name | JAANVI BHAGAT
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Credential |
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Telephone | 215-237-1525
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State |
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