Eagles Oral Surgery
Organization Active NPI Oral and Maxillofacial Surgery (Dentist) · Gilbertsville, PA
NPI 1720619612 · NPPES record last updated Jan 29, 2020
Key facts
- NPI
- 1720619612
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Oral and Maxillofacial Surgery (Dentist) 1223S0112X
- Legal business name
- EAGLES ORAL SURGERY
- Practice address
- 1037 E Philadelphia Ave
Gilbertsville, PA 19525-9516 - Phone
- (484) 773-1717
- Fax
- (484) 773-1717
- NPI assigned
- Jan 29, 2020
- Organization subpart
- No
Authorized official
- Name
- Megan Shank
- Title
- Quality Control Manager
- Phone
- (610) 372-6313
Corporate family (same tax ID) 13
National Provider Directory
- Tax ID family
- Eagles Oral Surgery
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) |
1223S0112X | Yes |
Addresses
Primary practice location
1037 E Philadelphia Ave
Gilbertsville, PA 19525-9516
Mailing address
1301 Penn Ave
Wyomissing, PA 19610-2140
Phone (484) 773-1717
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All providers in Gilbertsville, PA · Oral and Maxillofacial Surgery (Dentist) in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 29, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.