# DELAWARE VALLEY ORAL & MAXILLOFACIAL SURGICAL ASSOCIATES

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

## Provider details

- **NPI number:** 1760792766
- **Authorized official:** DR. JOSEPH A ILACQUA DDS (OWNER)
- **Authorized official phone:** (610) 275-0500

## Contact information

- **Practice address:** 2603 DEKALB PIKE, NORRISTOWN, PA 19401-1818
- **Practice address phone:** (610) 275-0500
- **Practice address fax:** (610) 275-1054
- **Mailing address:** 2603 DEKALB PIKE, NORRISTOWN, PA 19401-1818
- **Mailing address phone:** (610) 275-0500
- **Mailing address fax:** (610) 275-1054

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | DS019424L | PA | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | DS022706L | PA | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | DS022786L | PA | — |

## Other

- **Enumeration date:** 10/12/2010
- **Last updated:** 10/12/2010