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General NPI Number Information
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NPI Number | 1477661353
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Entity Type | Organization
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Legal Business Name | MAYNES & RENGER DENTISTRY
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Dates
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Enumeration Date | 08/29/2006
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Last Update Date | 08/19/2008
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Provider Practice Location Address
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Address Line | 1615 LIMEKILN PIKE
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City | DRESHER
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State | PA
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Zip | 19025-1007
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Country | US
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Telephone | 215-643-4740
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Fax | 215-643-9131
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Provider Business Mailing Address
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Address Line | 1615 LIMEKILN PIKE
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City | DRESHER
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State | PA
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Zip | 19025-1007
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Country | US
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Telephone | 215-643-4740
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Fax | 215-643-9131
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | MRS. XIN MU RENGER
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Credential | D.D.S
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Telephone | 215-643-4740
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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 | 035076
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License Number State | PA
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