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General NPI Number Information
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NPI Number | 1548415243
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Entity Type | Organization
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Legal Business Name | ADVANCED DENTISTRY OF COLLEGEVILLE PC
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Dates
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Enumeration Date | 11/21/2008
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Last Update Date | 08/19/2013
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Provider Practice Location Address
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Address Line | 399 ARCOLA RD SUITE 100
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City | COLLEGEVILLE
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State | PA
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Zip | 19426-3906
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Country | US
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Telephone | 610-489-5555
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Fax | 610-489-5163
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Provider Business Mailing Address
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Address Line | 399 ARCOLA RD SUITE 100
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City | COLLEGEVILLE
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State | PA
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Zip | 19426-3906
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Country | US
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Telephone | 610-489-5555
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. EME NELLY SILVA
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Credential | DMD
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Telephone | 610-489-5555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number | DS036175
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number | DS036175
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 1223D0004X
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Taxonomy Name | Dental Anesthesiology
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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