Organization
BRANDYWINE VALLEY ORAL & MAXIOLLOFACIAL SURGERY
Active
Other names
BVOMS
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT D WHITLEY D.D.D. (OWNER/DOCTOR)
(717) 442-9537
Entity
Organization
Contact information
Practice address
5279 LINCOLN HWY, GAP, PA 17527-9427
(717) 442-9537
(717) 442-8311
Mailing address
5279 LINCOLN HWY, GAP, PA 17527-9427
(717) 442-9537
(717) 442-8311
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0132579000
KEYSTONE EAST
PA
01
—
02628400
CAPITAL BLUE CROSS
PA
01
—
200631
KEYSTONE CENTRAL
PA
Enumeration date
09/26/2006
Last updated
08/22/2020
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