Individual
DR. MANSOOR MADANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
15 N PRESIDENTIAL BLVD, SUITE 301, BALA CYNWYD, PA 19004-1006
(610) 667-4455
Mailing address
15 PRESIDENTIAL BLVD, SUITE 301, BALA CYNWYD, PA 19004-1006
(610) 667-4455
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS023126L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1610569
UNITED CONCORDIA
PA
01
—
172847
BLUE SHIELD
PA
01
—
4517236
AETNA
PA
01
—
MA172847
HIGHMARK
PA
Enumeration date
12/26/2007
Last updated
03/04/2022
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