| Endodontic Specialist, P.c. | |
|
85 Old Eagle School Rd Wayne PA 19087-2544 | |
| (610) 995-0109 | |
| (610) 995-0107 |
| Full Name | Endodontic Specialist, P.c. |
|---|---|
| Speciality | Dentist - Endodontics |
| Location | 85 Old Eagle School Rd, Wayne, Pennsylvania |
| Authorized Official Name and Position | Bruce R Terry (OWNER) |
| Authorized Official Contact | 6109950109 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Endodontic Specialist, P.c. 85 Old Eagle School Rd Wayne PA 19087-2544 Ph: (610) 995-0109 | Endodontic Specialist, P.c. 85 Old Eagle School Rd Wayne PA 19087-2544 Ph: (610) 995-0109 |
| NPI Number | 1528116738 |
|---|---|
| Provider Enumeration Date | 01/07/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528116738 | NPI | - | NPPES |
| DS-025210L | Other | PA | DENTAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223E0200X | Dentist - Endodontics | DS-025210L (Pennsylvania) | Primary |
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