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General NPI Number Information
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NPI Number | 1437466208
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Entity Type | Organization
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Legal Business Name | HARELYSVILLE FAMILY DENTISTRY
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Dates
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Enumeration Date | 09/01/2010
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Last Update Date | 09/01/2010
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Provider Practice Location Address
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Address Line | 1111 FORTY FOOT ROAD
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City | KULPSVILLE
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State | PA
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Zip | 19443-0220
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Country | US
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Telephone | 215-362-8166
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Fax | 215-368-4235
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Provider Business Mailing Address
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Address Line | PO BOX 220 1111 FORTY FOOT ROAD
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City | KULPSVILLE
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State | PA
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Zip | 19443
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Country | US
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Telephone | 215-362-8166
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Fax | 215-368-4235
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | DR. STEPHEN E SULZBACH
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Credential | DMD
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Telephone | 215-362-8166
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DS037756
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License Number State | PA
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