# COMMONWEALTH OF PENNSYLVANIA MOBILE DENTISTRY,INC

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

## Provider details

- **NPI number:** 1417104761
- **Authorized official:** MS. LYNNE L BUKOFSKY (PRESIDENT)
- **Authorized official phone:** (732) 492-6218

## Contact information

- **Practice address:** 4920 RTE 202 (OLD YORK RD), SUITE 2FF, BUCKINGHAM, PA 18912
- **Practice address phone:** (215) 794-3404
- **Practice address fax:** (215) 794-8873
- **Mailing address:** 4920 RTE 202 (OLD YORK RD), SUITE 2FF, BUCKINGHAM, PA 18912
- **Mailing address phone:** (215) 794-3404
- **Mailing address fax:** (215) 794-8873

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | NULL | Yes |
| 122300000X | Dentist | — | — | Yes |
| 1223P0300X | Periodontics | — | NULL | — |
| 1223P0300X | Periodontics | — | — | — |

## Other

- **Enumeration date:** 08/19/2008
- **Last updated:** 08/19/2008