# MONTCO ORAL AND MAXILLOFACIAL SURGERY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043496599
- **Authorized official:** MRS. MARY E LUKAS (OFFICE MANAGER)
- **Authorized official phone:** (610) 489-0525

## Contact information

- **Practice address:** 545 W MAIN ST, SUITE 24, TRAPPE, PA 19426-1981
- **Practice address phone:** (610) 489-0525
- **Practice address fax:** (610) 489-4720
- **Mailing address:** 545 W MAIN ST, SUITE 24, TRAPPE, PA 19426-1981
- **Mailing address phone:** (610) 489-0525
- **Mailing address fax:** (610) 489-4720

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | DS024305 | PA | Yes |

## Other

- **Enumeration date:** 01/15/2008
- **Last updated:** 01/15/2008