Provider Demographics
NPI:1710107065
Name:APEX DENTAL CARE, LLC
Entity Type:Organization
Organization Name:APEX DENTAL CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:IGOR
Authorized Official - Middle Name:GARY
Authorized Official - Last Name:SHMURAK
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:215-996-9968
Mailing Address - Street 1:1600 HORIZON DR.
Mailing Address - Street 2:SUITE 119
Mailing Address - City:CHALFONT
Mailing Address - State:PA
Mailing Address - Zip Code:18914
Mailing Address - Country:US
Mailing Address - Phone:215-996-9968
Mailing Address - Fax:215-996-9971
Practice Address - Street 1:1600 HORIZON DR.
Practice Address - Street 2:SUITE 119
Practice Address - City:CHALFONT
Practice Address - State:PA
Practice Address - Zip Code:18914
Practice Address - Country:US
Practice Address - Phone:215-996-9968
Practice Address - Fax:215-996-9971
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-27
Last Update Date:2013-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS 036591261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental