Provider Demographics
NPI:1710191697
Name:BARBOZA, MARIAHELENA CORDEIRO (DMD)
Entity Type:Individual
Prefix:DR
First Name:MARIAHELENA
Middle Name:CORDEIRO
Last Name:BARBOZA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 WASHINGTON LN
Mailing Address - Street 2:
Mailing Address - City:WYNCOTE
Mailing Address - State:PA
Mailing Address - Zip Code:19095-1528
Mailing Address - Country:US
Mailing Address - Phone:610-459-5002
Mailing Address - Fax:610-459-5468
Practice Address - Street 1:275 WILMINGTON W CHESTER PK
Practice Address - Street 2:SUITE111
Practice Address - City:CHADDS FORD
Practice Address - State:PA
Practice Address - Zip Code:19317-9077
Practice Address - Country:US
Practice Address - Phone:610-459-5002
Practice Address - Fax:610-459-5468
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS025344-L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA481997OtherUNITED CONCORDIA