MEDICARE: YARDLEY PROSTHODONTICS PLLC

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	1223P0700X	Prosthodontics

General Provider Information

NPI Number	:	1104783984
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YARDLEY PROSTHODONTICS PLLC

Provider Business Mailing Address
First Line	:	307 FLORAL VALE BLVD
Second Line	:
City	:	YARDLEY
State	:	PA
Zip	:	19067-5525
Country	:	US
Telephone Number	:	215-860-0585
Fax Number	:	215-860-2214

Provider Business Practice Location Address
First Line	:	307 FLORAL VALE BLVD
Second Line	:
City	:	YARDLEY
State	:	PA
Zip	:	19067-5525
Country	:	US
Telephone Number	:	215-860-0585
Fax Number	:	215-860-2214

Authorized Official
Title or Position	:	MAXILLOFACIAL PROSTHODONTIST
Name	:	DR. HARRISON ISAAC SPATZ
Credential	:	DMD, MS, FACP, FAAMP
Telephone Number	:	516-457-5455

Provider Enumeration Date	:	01/05/2026
Last Update Date	:	01/05/2026

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