| Spark Oral Surgery Pa, Pllc | |
|
330 Laurel Mall Hazle Township PA 18202-1205 | |
| (610) 223-7777 | |
| Not Available |
| Full Name | Spark Oral Surgery Pa, Pllc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 330 Laurel Mall, Hazle Township, Pennsylvania |
| Authorized Official Name and Position | Phi Le (GENERAL COUNSEL) |
| Authorized Official Contact | 2675752321 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Spark Oral Surgery Pa, Pllc 300 Willowbrook Ln Ste 330 West Chester PA 19382-5594 Ph: () - | Spark Oral Surgery Pa, Pllc 330 Laurel Mall Hazle Township PA 18202-1205 Ph: (610) 223-7777 |
| NPI Number | 1316728652 |
|---|---|
| Provider Enumeration Date | 10/12/2023 |
| Last Update Date | 08/15/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316728652 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |