Individual
DR. MICHAEL J. MUNDENAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
606 FLORAL VALE BLVD, YARDLEY, PA 19067-5528
(215) 504-0600
(215) 504-0951
Mailing address
606 FLORAL VALE BLVD, YARDLEY, PA 19067-5528
(215) 504-0600
(215) 504-0951
Taxonomy
Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
DS-024081-L
PA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DS024081L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00042493000
KEYSTONE HEALTH PLAN EAST
PA
01
—
166433
HIGHMARK/BLUE SHIELD
PA
01
—
68626
AETNA ID #
PA
01
—
WA190229655
MEDICARE RR #
PA
Enumeration date
07/24/2006
Last updated
06/22/2015
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