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General NPI Number Information
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NPI Number | 1477673382
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Entity Type | Organization
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Legal Business Name | ELLIOT RAMER, DMD FAMILY DENTISTRY
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Dates
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Enumeration Date | 04/02/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1991 SPROUL RD STE 650 MAIN LINE HEALTH CENTER
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City | BROOMALL
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State | PA
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Zip | 19008-3520
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Country | US
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Telephone | 610-325-1670
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Fax | 610-325-1675
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Provider Business Mailing Address
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Address Line | 1991 SPROUL RD STE 650 MAIN LINE HEALTH CENTER
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City | BROOMALL
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State | PA
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Zip | 19008-3520
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Country | US
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Telephone | 610-325-1670
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Fax | 610-325-1675
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Authorized Official
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Title or Position | OWNER
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Name | DR. ELLIOT RAMER
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Credential | DMD
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Telephone | 610-325-1670
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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 | DS017451L
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License Number State | PA
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