Organization
DELAWARE VALLEY ORAL & MAXILLOFACIAL SURGICAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH A ILACQUA DDS (OWNER)
(610) 275-0500
Entity
Organization
Contact information
Practice address
2603 DEKALB PIKE, NORRISTOWN, PA 19401-1818
(610) 275-0500
(610) 275-1054
Mailing address
2603 DEKALB PIKE, NORRISTOWN, PA 19401-1818
(610) 275-0500
(610) 275-1054
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DS019424L
PA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DS022706L
PA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DS022786L
PA
Other
Enumeration date
10/12/2010
Last updated
10/12/2010
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