Provider Demographics
NPI:1144327156
Name:MICHAEL A MENDLOWSKI DDS PC
Entity type:Organization
Organization Name:MICHAEL A MENDLOWSKI DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DDS PC PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:MENDLOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:215-345-8030
Mailing Address - Street 1:875 NORTH EASTON RD
Mailing Address - Street 2:SUITE B1
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18902-1029
Mailing Address - Country:US
Mailing Address - Phone:215-345-8030
Mailing Address - Fax:215-345-0918
Practice Address - Street 1:875 NORTH EASTON RD
Practice Address - Street 2:SUITE B1
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18902-1029
Practice Address - Country:US
Practice Address - Phone:215-345-8030
Practice Address - Fax:215-345-0918
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA21895122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty