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General NPI Number Information
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NPI Number | 1659636116
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Entity Type | Organization
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Legal Business Name | AMERI DENTAL GROUP P.C.
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Dates
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Enumeration Date | 07/11/2012
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Last Update Date | 07/11/2012
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Provider Practice Location Address
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Address Line | 43 SOUTH LANSDOWNE AVENUE
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City | LANSDOWNE
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State | PA
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Zip | 19050
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Country | US
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Telephone | 610-623-7610
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Fax | 610-623-0023
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Provider Business Mailing Address
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Address Line | 43 SOUTH LANSDOWNE AVENUE
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City | LANSDOWNE
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State | PA
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Zip | 19050
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Country | US
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Telephone | 610-623-7610
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Fax | 610-623-0023
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | DONNA JOZWIAK
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Credential |
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Telephone | 610-623-7610
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DS036851
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License Number State | PA
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