# MONTGOMERY EMERGENCY DENTIST LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MONTGOMERY EMERGENCY DENTIST LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053950444
- **Authorized official:** NICK SHARKOV (MANAGER)
- **Authorized official phone:** (215) 475-5140

## Contact information

- **Practice address:** 396 DOYLESTOWN RD, MONTGOMERYVILLE, PA 18936-9609
- **Practice address phone:** (215) 475-5140
- **Practice address fax:** (215) 475-5245
- **Mailing address:** 396 DOYLESTOWN RD, MONTGOMERYVILLE, PA 18936-9609
- **Mailing address phone:** (121) 547-5514
- **Mailing address fax:** (215) 475-5245

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 01/02/2020
- **Last updated:** 01/02/2020