Organization
LOFTUS-MERMER ORAL SURGICAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT W MERMER D.D.S. (PRESIDENT)
(215) 281-3400
Entity
Organization
Contact information
Practice address
10101 ACADEMY RD, SUITE 203, PHILADELPHIA, PA 19114-1120
(215) 281-3400
(215) 281-3477
Mailing address
10101 ACADEMY RD, SUITE 203, PHILADELPHIA, PA 19114-1120
(215) 281-3400
(215) 281-3477
Taxonomy
Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0060890000
KEYSTONE
PA
01
—
17411
AETNA
PA
01
—
175253
BLUE SHIELD
PA
Enumeration date
09/21/2006
Last updated
08/22/2020
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