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. |
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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 |
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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 |
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Provider Enumeration Date | 02/25/2014 |
Last Update Date | 02/25/2014 |
Medicare PECOS PAC ID | 7416263355 |
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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 |
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Provider Type | Practitioner - Maxillofacial Surgery |
Provider Identifiers | NPI Number: 1700945938 PECOS PAC ID: 8729110309 Enrollment ID: I20100716000576 |
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