Organization
NORTH PENN ENDODONTICS LTD II
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NEIL LARRY BALICK DDS (PRESIDENT)
(215) 855-1173
Entity
Organization
Contact information
Practice address
2100 N BROAD STREET, SUITE 201, LANSDALE, PA 19446
(215) 855-1173
(215) 855-1936
Mailing address
2100 N BROAD STREET, SUITE 201, LANSDALE, PA 19446
(215) 855-1173
(215) 855-1936
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
—
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
054393
BLUE SHIELD
—
01
—
113237
CIGNA
—
01
—
1560
AETNA DMO
—
01
—
89839
AETNA
—
Enumeration date
07/15/2006
Last updated
08/22/2020
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