| Anthony Farole Dmd, Inc. | |
|
191 Presidential Blvd W2 Bala Cynwyd PA 19004-1207 | |
| (610) 668-3300 | |
| (610) 668-4038 |
| Full Name | Anthony Farole Dmd, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 191 Presidential Blvd, Bala Cynwyd, Pennsylvania |
| Authorized Official Name and Position | Anthony Farole (PRESIDENT) |
| Authorized Official Contact | 6106683300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Anthony Farole Dmd, Inc. 380 Shelbourne Ln Phoenixville PA 19460-5743 Ph: (610) 668-3300 | Anthony Farole Dmd, Inc. 191 Presidential Blvd W2 Bala Cynwyd PA 19004-1207 Ph: (610) 668-3300 |
| NPI Number | 1225453442 |
|---|---|
| Provider Enumeration Date | 02/25/2014 |
| Last Update Date | 02/25/2014 |
| Medicare PECOS PAC ID | 7416263355 |
|---|---|
| Medicare Enrollment ID | O20150908002775 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225453442 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | DS022779L (Pennsylvania) | Primary |
| Provider Name | Anthony Farole |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1700945938 PECOS PAC ID: 8729110309 Enrollment ID: I20100716000576 |
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