| Montgomery Mall Dental, Llp | |
|
154 Montgomery Mall North Wales PA 19454-3909 | |
| (215) 356-6666 | |
| Not Available |
| Full Name | Montgomery Mall Dental, Llp |
|---|---|
| Speciality | Dentist |
| Location | 154 Montgomery Mall, North Wales, Pennsylvania |
| Authorized Official Name and Position | Viktoriya I Shaakova (OFFICE MANAGER) |
| Authorized Official Contact | 2153625666 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Montgomery Mall Dental, Llp 154 Montgomery Mall North Wales PA 19454-3909 Ph: (215) 356-6666 | Montgomery Mall Dental, Llp 154 Montgomery Mall North Wales PA 19454-3909 Ph: (215) 356-6666 |
| NPI Number | 1770821761 |
|---|---|
| Provider Enumeration Date | 01/25/2013 |
| Last Update Date | 01/25/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770821761 | NPI | - | NPPES |
| 193200000X | Other | PA | MULTI-SPECIALTY GROUP |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DS038562 (Pennsylvania) | Primary |
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