| Boulevard Dental Associates | |
|
430 Kenhorst Blvd Reading PA 19611-1830 | |
| (610) 775-0321 | |
| (610) 777-8884 |
| Full Name | Boulevard Dental Associates |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 430 Kenhorst Blvd, Reading, Pennsylvania |
| Authorized Official Name and Position | Timothy Medianick (OWNER) |
| Authorized Official Contact | 6107750321 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Boulevard Dental Associates 430 Kenhorst Blvd Reading PA 19611-1830 Ph: (610) 775-0321 | Boulevard Dental Associates 430 Kenhorst Blvd Reading PA 19611-1830 Ph: (610) 775-0321 |
| NPI Number | 1659509404 |
|---|---|
| Provider Enumeration Date | 06/30/2009 |
| Last Update Date | 07/27/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659509404 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DS036510 (Pennsylvania) | Primary |
| 1223G0001X | Dentist - General Practice | DN017638 (Pennsylvania) | Secondary |
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