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Individual

DR. BERNARD DAVID SERVAGNO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
821 DELAWARE AVE, FOUNTAIN HILL, PA 18015-1179
(610) 882-9910
(610) 882-1747
Mailing address
821 DELAWARE AVE, FOUNTAIN HILL, PA 18015-1179
(610) 882-9910
(610) 882-1747

Taxonomy

Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
DS025898-L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4652440001
NAT'L SUPPLIER
PA
01
DS025898-L
LICENCE NUMBER
PA
Enumeration date
07/27/2006
Last updated
07/08/2007
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