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General NPI Number Information
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NPI Number | 1710004155
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Entity Type | Organization
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Legal Business Name | WBG DENTISTRY INC
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Dates
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Enumeration Date | 03/22/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 920 LAWN AVE STE E1
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City | SELLERSVILLE
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State | PA
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Zip | 18960-1560
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Country | US
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Telephone | 215-453-6630
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Fax | 215-453-6909
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Provider Business Mailing Address
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Address Line | 920 LAWN AVE STE E1
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City | SELLERSVILLE
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State | PA
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Zip | 18960-1560
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Country | US
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Telephone | 215-453-6630
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Fax | 215-453-6909
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. ISABELLA GARCIA
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Credential |
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Telephone | 215-453-6630
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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 | DX001157L
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License Number State | PA
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