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General NPI Number Information
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NPI Number | 1982101325
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Entity Type | Organization
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Legal Business Name | MERION FAMILY DENTISTRY
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Dates
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Enumeration Date | 04/11/2018
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Last Update Date | 04/11/2018
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Provider Practice Location Address
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Address Line | 352 MONTGOMERY AVE
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City | MERION STATION
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State | PA
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Zip | 19066-1202
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Country | US
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Telephone | 484-278-4441
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Fax |
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Provider Business Mailing Address
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Address Line | 352 MONTGOMERY AVE
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City | MERION STATION
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State | PA
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Zip | 19066-1202
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Country | US
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Telephone | 484-278-4441
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | DR. DANA KUPFER
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Credential |
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Telephone | 973-493-3814
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | DS039334
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License Number State | PA
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