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General NPI Number Information
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NPI Number | 1639825433
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Entity Type | Organization
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Legal Business Name | GREAT VALLEY ORTHODONTICS LLC
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Dates
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Enumeration Date | 03/01/2022
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Last Update Date | 06/05/2022
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Provider Practice Location Address
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Address Line | 596 LANCASTER AVE STE 100
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City | MALVERN
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State | PA
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Zip | 19355-1808
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Country | US
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Telephone | 203-858-0767
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Fax |
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Provider Business Mailing Address
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Address Line | 596 LANCASTER AVE STE 100
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City | MALVERN
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State | PA
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Zip | 19355-1808
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Country | US
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Telephone | 610-956-9922
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Fax |
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Authorized Official
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Title or Position | ORTHODONTIST/OWNER
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Name | DR. MATTHEW SILVER
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Credential | DMD
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Telephone | 610-956-9922
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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