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General NPI Number Information
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NPI Number | 1508808437
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Entity Type | Individual
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Provider Name | MARK PAUL ELSTEIN D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/12/2006
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Last Update Date | 03/31/2011
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Provider Practice Location Address
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Address Line | 1402 W BROAD ST SUITE 101
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City | QUAKERTOWN
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State | PA
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Zip | 18951-1110
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Country | US
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Telephone | 215-536-8133
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Fax | 215-529-9498
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Provider Business Mailing Address
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Address Line | 1402 W BROAD ST SUITE 101
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City | QUAKERTOWN
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State | PA
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Zip | 18951-1110
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Country | US
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Telephone | 215-536-8133
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Fax | 215-529-9498
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | DS017798L
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License Number State | PA
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