Organization
BRIAN R HABER DDS & JOSEPH A ILACQUA DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH ANTHONY ILACQUA DDS (PRESIDENT OWNER)
(610) 275-0500
Entity
Organization
Contact information
Practice address
2603 DEKALB PIKE, NORRISTOWN, PA 19401
(610) 275-0500
(610) 275-1054
Mailing address
2603 DEKALB PIKE, NORRISTOWN, PA 19401
(610) 275-0500
(610) 275-1054
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
DS019424L
PA
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
DS022706L
PA
Other
Enumeration date
07/16/2006
Last updated
06/18/2008
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