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Oral Surgery, Dental Specialists

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ABOUT YOUR SMILE, PC

Dentist

Upper Darby, Pennsylvania

Provider NPI: 1346214954

Organization Information:
Organization Name:  ABOUT YOUR SMILE, PC
Organization is not Subpart
Authorized Official:  GLENN A BROWN  PRESIDENT  610-7340666

Practice Location:
6776 MARKET ST  UPPER DARBY, PA 19082 US
Tel: 610-734-0115  Fax: --

Business Mailing Address:
6776 MARKET ST  UPPER DARBY, PA 19082 US
Tel: 610-734-0115  Fax: --

Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
X122300000XDental Providers
Dentist
PADS 023270 L
X1223E0200XDental Providers
Dentist
PADS 025089 L

Other Provider Identifiers:

IssuerNumberStateType
0009098000001PA05
UNITED CONCORDIA401786PA01
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin



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