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General NPI Number Information
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NPI Number | 1528024700
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Entity Type | Organization
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Legal Business Name | WYOMISSING ORAL SURGICAL ASSOCS, LTD
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Dates
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Enumeration Date | 04/25/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 6 HEARTHSTONE CT SUITE 301
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City | READING
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State | PA
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Zip | 19606-3065
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Country | US
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Telephone | 610-370-2300
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Fax | 610-370-2303
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Provider Business Mailing Address
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Address Line | 6 HEARTHSTONE CT SUITE 301
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City | READING
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State | PA
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Zip | 19606-3065
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Country | US
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Telephone | 610-370-2300
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Fax | 610-370-2303
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Authorized Official
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Title or Position | OWNER
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Name | DR. ARTHUR F DOUGLASS JR.
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Credential | D.D.S.
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Telephone | 610-370-2300
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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 | DS022591L
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License Number State | PA
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