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General NPI Number Information
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NPI Number | 1588572150
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Entity Type | Organization
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Legal Business Name | UNIVERSAL DENTISTRY PROFESSIONAL ASSOCIATION
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Dates
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Enumeration Date | 09/01/2026
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Last Update Date | 09/01/2026
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Provider Practice Location Address
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Address Line | 5851 BLACK HORSE PIKE
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City | TURNERSVILLE
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State | NJ
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Zip | 08012-1460
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Country | US
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Telephone | 215-630-2872
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Fax |
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Provider Business Mailing Address
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Address Line | 1919 SUSQUEHANNA RD
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City | ABINGTON
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State | PA
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Zip | 19001-4513
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Country | US
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Telephone | 215-630-2872
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Fax |
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Authorized Official
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Title or Position | EVP OF LEGAL & BUSINESS
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Name | TODD VON VITAL
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Credential |
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Telephone | 215-630-2872
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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 |
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License Number State |
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