MEDICARE: ROYERSFORD DENTAL CARE INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	DS036595	PA

General Provider Information

NPI Number	:	1043485931
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROYERSFORD DENTAL CARE INC.

Provider Business Mailing Address
First Line	:	301 N LEWIS RD
Second Line	:	#25
City	:	ROYERSFORD
State	:	PA
Zip	:	19468-1531
Country	:	US
Telephone Number	:	610-948-0531
Fax Number	:

Provider Business Practice Location Address
First Line	:	301 N LEWIS RD
Second Line	:	#25
City	:	ROYERSFORD
State	:	PA
Zip	:	19468-1531
Country	:	US
Telephone Number	:	610-948-0531
Fax Number	:

Authorized Official
Title or Position	:	DENTIST
Name	:	NING ZHANG
Credential	:	DMD
Telephone Number	:	858-603-2616

Provider Enumeration Date	:	04/23/2008
Last Update Date	:	04/23/2008

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