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General NPI Number Information
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NPI Number | 1457255432
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Entity Type | Organization
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Legal Business Name | GLENSIDE ORTHODONTICS PLLC
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Dates
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Enumeration Date | 10/05/2026
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Last Update Date | 10/05/2026
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Provider Practice Location Address
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Address Line | 400 GREENWOOD AVE
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City | WYNCOTE
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State | PA
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Zip | 19095-1825
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Country | US
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Telephone | 267-735-2770
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Fax | 267-735-2779
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Provider Business Mailing Address
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Address Line | 400 GREENWOOD AVE
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City | WYNCOTE
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State | PA
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Zip | 19095-1825
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Country | US
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Telephone | 267-735-2770
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Fax | 267-735-2779
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Authorized Official
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Title or Position | OWNER/ ORTHODONTICS
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Name | DR. KELLY MCMONAGLE
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Credential | DMD, MSD
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Telephone | 484-744-8640
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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 | NULL
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