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General NPI Number Information
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NPI Number | 1407061161
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Entity Type | Individual
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Provider Name | ROBERT DAVID MOGYOROS DMD
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Gender | Male
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Dates
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Enumeration Date | 05/14/2007
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Last Update Date | 01/31/2012
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Provider Practice Location Address
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Address Line | 401 TOWNSHIP LINE RD SUITE C
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City | ELKINS PARK
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State | PA
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Zip | 19027-2202
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Country | US
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Telephone | 215-379-3382
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Fax |
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Provider Business Mailing Address
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Address Line | 401 TOWNSHIP LINE RD
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City | ELKINS PARK
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State | PA
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Zip | 19027-2202
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Country | US
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Telephone | 215-379-3382
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DS035811
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | DS035811
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 9437
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License Number State | CO
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