Organization
COMMUNITY MEDICAL & DENTAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARY PATRICIA DAVIDSON (RN PRESIDENT)
(610) 489-1313
Entity
Organization
Contact information
Practice address
309 GRAVEL PIKE, RAHNS, PA 19426
(610) 489-1313
(610) 489-5859
Mailing address
309 GRAVEL PIKE, RAHNS, PA 19426
(610) 489-1313
(610) 489-5859
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
DS026149L
PA
1223G0001X
General Practice Dentistry
Primary
DS031471L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007461630001
—
PA
01
—
1150949
KMHP
PA
Enumeration date
12/28/2006
Last updated
08/22/2020
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