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General NPI Number Information
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NPI Number | 1972602621
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Entity Type | Organization
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Legal Business Name | LOFTUS-MERMER ORAL SURGICAL ASSOCIATES
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Dates
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Enumeration Date | 09/21/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 10101 ACADEMY RD SUITE 203
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City | PHILADELPHIA
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State | PA
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Zip | 19114-1120
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Country | US
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Telephone | 215-281-3400
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Fax | 215-281-3477
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Provider Business Mailing Address
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Address Line | 10101 ACADEMY RD SUITE 203
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City | PHILADELPHIA
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State | PA
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Zip | 19114-1120
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Country | US
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Telephone | 215-281-3400
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Fax | 215-281-3477
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ROBERT W MERMER
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Credential | D.D.S.
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Telephone | 215-281-3400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0106X
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Taxonomy Name | Oral and Maxillofacial Pathology Dentistry
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License Number |
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License Number State |
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