Provider Demographics
NPI:1083836704
Name:MENDLOWSKI, MICHAEL A (DDS)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:A
Last Name:MENDLOWSKI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:875 N EASTON RD
Mailing Address - Street 2:SUITE B-1
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18901-1068
Mailing Address - Country:US
Mailing Address - Phone:215-345-8030
Mailing Address - Fax:215-345-0918
Practice Address - Street 1:875 N EASTON RD
Practice Address - Street 2:SUITE B-1
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-1068
Practice Address - Country:US
Practice Address - Phone:215-345-8030
Practice Address - Fax:215-345-0918
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS021895L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice