Organization
ABOUT YOUR SMILE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GLENN A BROWN DMD (PRESIDENT)
(610) 734-0115
Entity
Organization
Contact information
Practice address
6776 MARKET ST, UPPER DARBY, PA 19082
(610) 734-0015
(610) 734-1419
Mailing address
6776 MARKET ST, UPPER DARBY, PA 19082
(610) 734-0015
(610) 734-1419
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0009098000001
—
PA
01
—
401786
UNITED CONCORDIA
—
Enumeration date
08/29/2006
Last updated
03/11/2014
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