Provider Demographics
NPI:1023657061
Name:MONTCO DENTAL ASSOCIATES, PLLC
Entity type:Organization
Organization Name:MONTCO DENTAL ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMPLIANCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:GREENFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-884-3477
Mailing Address - Street 1:330 MIDDLETOWN BLVD STE 401
Mailing Address - Street 2:
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-3204
Mailing Address - Country:US
Mailing Address - Phone:215-884-3477
Mailing Address - Fax:215-884-6638
Practice Address - Street 1:1919 SUSQUEHANNA RD
Practice Address - Street 2:
Practice Address - City:ABINGTON
Practice Address - State:PA
Practice Address - Zip Code:19001-4513
Practice Address - Country:US
Practice Address - Phone:215-884-3477
Practice Address - Fax:215-884-6638
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-21
Last Update Date:2019-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty