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NPI Code Detail

MEDICARE: DR. DALE M. HUPALO D.M.D.

MEDICARE: DR. DALE M. HUPALO D.M.D.
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
1122300000XDentistDS020303LPA

General Provider Information

NPI Number : 1366407017
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DALE M. HUPALO D.M.D.
Provider Business Mailing Address
First Line : 2805 OLD RODGERS RD
Second Line :
City : BRISTOL
State : PA
Zip : 19007-1723
Country : US
Telephone Number : 215-945-5199
Fax Number : 215-945-6290
Provider Business Practice Location Address
First Line : 7419 NEW FALLS RD
Second Line :
City : LEVITTOWN
State : PA
Zip : 19055-1008
Country : US
Telephone Number : 215-945-5199
Fax Number : 215-945-6290
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/18/2006
Last Update Date : 07/08/2007

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