Organization
MICHAEL J. MUNDENAR, D.M.D.,P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL JOSEPH MUNDENAR D.M.D. (PRESIDENT)
(215) 504-0600
Entity
Organization
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
Primary
DS-024081-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00042493000
KHPE
PA
01
—
166433
BLUE CROSS BLUE SHIELD
PA
01
—
68626
AETNA
PA
Enumeration date
03/26/2007
Last updated
08/22/2020
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