Organization
SUBURBAN ORAL SURGERY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALFRED JOHN WOLANIN JR. DDS (PRESIDENT)
(610) 449-2100
Entity
Organization
Contact information
Practice address
2010 W CHESTER PIKE, SUITE 128, HAVERTOWN, PA 19083-2700
(610) 449-2100
(610) 449-9415
Mailing address
2010 W CHESTER PIKE, SUITE 128, HAVERTOWN, PA 19083-2700
(610) 449-2100
(610) 449-9415
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
05/24/2006
Last updated
08/22/2020
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