# MAIN LINE PLASTIC SURGERY&LASER ASSOCIATES

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

## Provider details

- **NPI number:** 1356586028
- **Authorized official:** DR. RICHARD P. GLUNK M.D. (PRESIDENT)
- **Authorized official phone:** (610) 354-8800

## Contact information

- **Practice address:** 216 MALL BLVD, SUITE 101, KING OF PRUSSIA, PA 19406-2923
- **Practice address phone:** (610) 354-8800
- **Practice address fax:** (610) 354-9066
- **Mailing address:** 216 MALL BLVD, SUITE 101, KING OF PRUSSIA, PA 19406-2923
- **Mailing address phone:** (610) 354-8800

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 15511501 | PA | Yes |

## Other

- **Enumeration date:** 12/10/2008
- **Last updated:** 12/10/2008