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NPI Code Detail

MEDICARE: SMILE DESIGNERS OF NORTH WALES PC

MEDICARE: SMILE DESIGNERS OF NORTH WALES PC
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
11223G0001XGeneral Practice Dentistry

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11598974115OTHERPANPI
21245769454OTHERPANPI

General Provider Information

NPI Number : 1255896759
Entity Type Code : Organization
Provider Name (Legal Business Name) : SMILE DESIGNERS OF NORTH WALES PC
Provider Business Mailing Address
First Line : 118 DICKERSON RD STE D
Second Line :
City : NORTH WALES
State : PA
Zip : 19454-2538
Country : US
Telephone Number : 215-699-0650
Fax Number : 215-699-9599
Provider Business Practice Location Address
First Line : 118 DICKERSON RD STE D
Second Line :
City : NORTH WALES
State : PA
Zip : 19454-2538
Country : US
Telephone Number : 215-699-0650
Fax Number : 215-699-9599
Authorized Official
Title or Position : PRESIDENT
Name : DR. MATHEW K CHERIAN
Credential : DDS
Telephone Number : 215-699-0650
Provider Enumeration Date : 02/08/2019
Last Update Date : 02/08/2019

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Directions to “SMILE DESIGNERS OF NORTH WALES PC ” Practice Location

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