SOUTHEASTERN PA ORAL SURGERY LLC - NPI 1073641148

Q: What is Delaware Valley Maxillofacial & Oral Surgery LLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

On this page

About Southeastern Pa Oral Surgery Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTHEASTERN PA ORAL SURGERY LLC (NPI 1073641148) is a healthcare organization registered as an oral and maxillofacial surgery in Philadelphia, Pennsylvania and active in the NPI registry since March 2007. The organization maintains a secondary practice location in Philadelphia and lists Brian M Smith, Chairman, as its authorized official.

NPPES Registry Identity

NPI1073641148

Entity TypeOrganization

Primary Taxonomy1223S0112X

Legal Business NameDELAWARE VALLEY MAXILLOFACIAL & ORAL SURGERY LLC

Location Address2301 E ALLEGHENY AVE STE 206Philadelphia, PA 19134-4427

Mailing Address100 E Lehigh Ave, Pm2Philadelphia, PA 19125-1012 · (215) 707-7138 · Fax (215) 707-5405

Phone(267) 367-5009

Fax(267) 367-5476

Organization SubpartNo

Authorized OfficialBrian M SmithChairman · (215) 707-7138

Enumeration DateMarch 1, 2007

Last NPPES UpdateAugust 13, 2020

NPPES CertifiedAugust 13, 2020

✔ NPI 1073641148 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers

Taxonomy Code1223S0112X

Definition

An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.

2301 E ALLEGHENY AVE STE 206, Philadelphia, PA 19134

Open in Google Maps ↗

Other Names 1

Doing Business AsSoutheastern Pa Oral Surgery Llc

Secondary Practice Location 1

Location 1100 E Lehigh Ave, PM2Philadelphia, PA 19125-1012 · Phone (215) 707-7138 · Fax (215) 707-5405

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARC COLBY DDS

Student in an Organized Health Care Education/Training Program