MEDICARE: LINDSAY RAMBO D.M.D., M.S.

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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	DS040594	PA

General Provider Information

NPI Number	:	1053821975
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDSAY RAMBO D.M.D., M.S.

Provider Business Mailing Address
First Line	:	15 DETWEILER RD
Second Line	:
City	:	SELLERSVILLE
State	:	PA
Zip	:	18960-1611
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2120 N BROAD ST
Second Line	:
City	:	LANSDALE
State	:	PA
Zip	:	19446-1055
Country	:	US
Telephone Number	:	215-362-2810
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/05/2017
Last Update Date	:	10/05/2017

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