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Organization
JENKINTOWN ENDODONTICS, LLC
Active
Organization
JENKINTOWN ENDODONTICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALEXANDER FULLER DMD (PART OWNER/ ENDODONTIST)
(267) 255-0759
Entity
Organization
Contact information
Practice address
509 YORK RD, JENKINTOWN, PA 19046-2102
(267) 589-9636
Mailing address
509 YORK RD, JENKINTOWN, PA 19046-2102
(267) 589-9636
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
—
NULL
1223E0200X
Endodontics
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1508260274
NPI
—
Enumeration date
01/17/2019
Last updated
01/17/2019
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