Provider Demographics
NPI:1134356165
Name:SCHELLHORN, MARIA BERNARDITA (DMD)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:BERNARDITA
Last Name:SCHELLHORN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:744 W LANCASTER AVE
Mailing Address - Street 2:SUITE 115
Mailing Address - City:WAYNE
Mailing Address - State:PA
Mailing Address - Zip Code:19087-2523
Mailing Address - Country:US
Mailing Address - Phone:610-971-0717
Mailing Address - Fax:610-971-9781
Practice Address - Street 1:744 W LANCASTER AVE
Practice Address - Street 2:SUITE 115
Practice Address - City:WAYNE
Practice Address - State:PA
Practice Address - Zip Code:19087-2523
Practice Address - Country:US
Practice Address - Phone:610-971-0717
Practice Address - Fax:610-971-9781
Is Sole Proprietor?:No
Enumeration Date:2009-06-17
Last Update Date:2009-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS 0379321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice