Organization
ELKINS PARK ORAL SURGERY, INC
Active
Other names
Elkins Park Dental Specialist
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATHEW CHERIAN DDS (PRESIDENT)
(215) 663-1223
Entity
Organization
Contact information
Practice address
7900 OLD YORK RD, 115 A, ELKINS PARK, PA 19027-2318
(215) 635-0808
Mailing address
7900 OLD YORK RD, 115 A, ELKINS PARK, PA 19027-2318
(215) 635-0808
Taxonomy
Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
Primary
DS037551
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1022041470033
—
PA
Enumeration date
03/05/2013
Last updated
08/13/2013
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