| Main Line Dental Group Pc | |
|
744 West Lancaster Ave Devon Square Ii Suite 115 Wayne PA 19087-2523 | |
| (610) 971-0717 | |
| (610) 971-9781 |
| Full Name | Main Line Dental Group Pc |
|---|---|
| Speciality | Dentist - Prosthodontics |
| Location | 744 West Lancaster Ave, Wayne, Pennsylvania |
| Authorized Official Name and Position | Ronald Craig Williams (OWNER PRESIDENT) |
| Authorized Official Contact | 6109710717 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Main Line Dental Group Pc 744 W Lancaster Ave Devon Square Ii Suite 115 Wayne PA 19087-2523 Ph: (610) 971-0717 | Main Line Dental Group Pc 744 West Lancaster Ave Devon Square Ii Suite 115 Wayne PA 19087-2523 Ph: (610) 971-0717 |
| NPI Number | 1679618433 |
|---|---|
| Provider Enumeration Date | 02/20/2007 |
| Last Update Date | 07/19/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679618433 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0700X | Dentist - Prosthodontics | DS022342L (Pennsylvania) | Primary |
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