Organization
MY FAVORITE DENTAL CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HUIFANG MA (OWNER)
(267) 663-8699
Entity
Organization
Contact information
Practice address
508 PRUDENTIAL RD, SUITE 300, HORSHAM, PA 19044-2309
(267) 663-8699
Mailing address
508 PRUDENTIAL RD, SUITE 300, HORSHAM, PA 19044-2309
(267) 663-8699
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS039534
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102813274-0001
—
PA
Enumeration date
07/13/2015
Last updated
07/13/2015
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