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General NPI Number Information
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NPI Number | 1528124427
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Entity Type | Organization
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Legal Business Name | COMMUNITY MEDICAL & DENTAL CENTER
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Dates
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Enumeration Date | 12/28/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 309 GRAVEL PIKE
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City | RAHNS
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State | PA
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Zip | 19426
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Country | US
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Telephone | 610-489-1313
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Fax | 610-489-5859
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Provider Business Mailing Address
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Address Line | 309 GRAVEL PIKE
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City | RAHNS
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State | PA
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Zip | 19426
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Country | US
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Telephone | 610-489-1313
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Fax | 610-489-5859
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Authorized Official
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Title or Position | RN PRESIDENT
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Name | MRS. MARY PATRICIA DAVIDSON
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Credential |
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Telephone | 610-489-1313
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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 | DS026149L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DS031471L
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License Number State | PA
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