MEDICARE: DR STANLEY J WASKO , DDS & ASSOCIATES, P.C.

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	1223G0001X	General Practice Dentistry	DS026266L	PA

General Provider Information

NPI Number	:	1871635425
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR STANLEY J WASKO , DDS & ASSOCIATES, P.C.

Provider Business Mailing Address
First Line	:	3428 RHAWN ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19136-2610
Country	:	US
Telephone Number	:	215-331-1330
Fax Number	:	215-331-3394

Provider Business Practice Location Address
First Line	:	3428 RHAWN ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19136-2610
Country	:	US
Telephone Number	:	215-331-1330
Fax Number	:	215-331-3394

Authorized Official
Title or Position	:	DENTIST OWNER
Name	:	DR. KAREN B WASKO
Credential	:	D.M.D.
Telephone Number	:	215-331-1330

Provider Enumeration Date	:	02/12/2007
Last Update Date	:	08/22/2020

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