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General NPI Number Information
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NPI Number | 1831317254
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Entity Type | Organization
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Legal Business Name | UPPER MERION PERIODONTAL ASSOCIATES
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Dates
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Enumeration Date | 04/23/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 357 S GULPH RD SUITE 100
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City | KING OF PRUSSIA
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State | PA
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Zip | 19406-3174
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Country | US
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Telephone | 610-337-2325
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Fax | 610-337-3863
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Provider Business Mailing Address
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Address Line | 357 S GULPH RD SUITE 100
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City | KING OF PRUSSIA
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State | PA
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Zip | 19406-3174
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Country | US
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Telephone | 610-337-3863
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. SCOTT SMITH
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Credential | DDS
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Telephone | 610-337-2325
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number |
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License Number State |
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