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Organization
MAINLINE CENTER FOR ORAL & FACIAL SURGERY LTD
Active
Organization
MAINLINE CENTER FOR ORAL & FACIAL SURGERY LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HENRY M RAMBO DDS (CEO PRESIDENT)
(610) 644-6497
Entity
Organization
Contact information
Practice address
21 INDUSTRIAL BLVD, #100, PAOLI, PA 19301
(610) 644-6497
(610) 644-6622
Mailing address
21 INDUSTRIAL BLVD, #100, PAOLI, PA 19301
(610) 644-6497
(610) 644-6622
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DS017526L
PA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DS023677L
PA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DS0277729L
PA
Other
Enumeration date
05/20/2006
Last updated
08/22/2020
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