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NPI 1760969992

NPI 1760969992 : YOUR ORTHODONTIST : LANGHORNE, PA

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General NPI Number Information
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    NPI Number           |    1760969992
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    Entity Type          |    Organization 
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    Legal Business Name  |    YOUR ORTHODONTIST 
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Dates
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    Enumeration Date     |    07/20/2018
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    Last Update Date     |    07/20/2018
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Provider Practice Location Address
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    Address Line         |    586 MIDDLETOWN BLVD STE C10 
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    City                 |    LANGHORNE
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    State                |    PA
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    Zip                  |    19047
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    Country              |    US
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    Telephone            |    215-750-7779
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    Fax                  |    215-750-7848
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Provider Business Mailing Address
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    Address Line         |    586 MIDDLETOWN BLVD STE C10 
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    City                 |    LANGHORNE
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    State                |    PA
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    Zip                  |    19047-1880
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    Country              |    US
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    Telephone            |    215-750-7779
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    Fax                  |    215-750-7848
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |    DR. RONALD J SAFFAR 
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    Credential           |    DDS
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    Telephone            |    215-750-7779
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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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