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General NPI Number Information
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NPI Number | 1407948326
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Entity Type | Organization
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Legal Business Name | NORTH PENN PERIODONTAL ASSOCIATES
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Dates
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Enumeration Date | 09/28/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2100 N BROAD ST STE. #204
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City | LANSDALE
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State | PA
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Zip | 19446-1052
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Country | US
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Telephone | 215-368-5110
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Fax | 215-368-2017
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Provider Business Mailing Address
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Address Line | 2100 N BROAD ST STE. #204
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City | LANSDALE
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State | PA
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Zip | 19446-1052
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Country | US
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Telephone | 215-368-5110
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Fax | 215-368-2017
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. ELSA WILLIAMS
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Credential |
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Telephone | 215-368-5110
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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 | DSO16258
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | DSO16352
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License Number State | PA
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