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NPI Code Detail

MEDICARE: INNOVARE DENTAL PLLC

MEDICARE: INNOVARE DENTAL 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
1261QD0000XDental Clinic/Center

General Provider Information

NPI Number : 1700744695
Entity Type Code : Organization
Provider Name (Legal Business Name) : INNOVARE DENTAL PLLC
Provider Business Mailing Address
First Line : 483 MAIN ST STE 260
Second Line :
City : HARLEYSVILLE
State : PA
Zip : 19438-2461
Country : US
Telephone Number : 267-428-6103
Fax Number :
Provider Business Practice Location Address
First Line : 483 MAIN ST STE 260
Second Line :
City : HARLEYSVILLE
State : PA
Zip : 19438-2461
Country : US
Telephone Number : 267-428-6103
Fax Number :
Authorized Official
Title or Position : MEMBER
Name : ERIC TRAN
Credential :
Telephone Number : 267-428-6103
Provider Enumeration Date : 01/12/2026
Last Update Date : 01/12/2026

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Directions to “INNOVARE DENTAL PLLC ” Practice Location

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