Provider Demographics
NPI:1831317254
Name:UPPER MERION PERIODONTAL ASSOCIATES
Entity Type:Organization
Organization Name:UPPER MERION PERIODONTAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:610-337-2325
Mailing Address - Street 1:357 S GULPH RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-3174
Mailing Address - Country:US
Mailing Address - Phone:610-337-3863
Mailing Address - Fax:
Practice Address - Street 1:357 S GULPH RD
Practice Address - Street 2:SUITE 100
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-3174
Practice Address - Country:US
Practice Address - Phone:610-337-2325
Practice Address - Fax:610-337-3863
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty