Individual
DR. MICHAEL L. EISENBROCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
3554 HULMEVILLE RD, SUITE 111, BENSALEM, PA 19020-4366
(215) 638-9952
(215) 638-1175
Mailing address
3554 HULMEVILLE RD, SUITE 111, BENSALEM, PA 19020-4366
(215) 638-9952
(215) 638-1175
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS019531L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
103205
UNITED CONCORDIA PROVIDER
PA
01
—
232209954
TAX ID
PA
01
—
DS019531L
LICENSE NUMBER
PA
Enumeration date
11/14/2006
Last updated
04/12/2017
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