Provider Demographics
NPI:1689465593
Name:BUXMONT PROSTHODONTICS & RESTORATIVE DENTISTRY LLC
Entity type:Organization
Organization Name:BUXMONT PROSTHODONTICS & RESTORATIVE DENTISTRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:STAFF
Authorized Official - Prefix:MRS
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:A
Authorized Official - Last Name:ROMANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-855-3233
Mailing Address - Street 1:2100 N BROAD ST STE 104
Mailing Address - Street 2:
Mailing Address - City:LANSDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19446-1052
Mailing Address - Country:US
Mailing Address - Phone:215-855-3233
Mailing Address - Fax:215-855-8029
Practice Address - Street 1:2100 N BROAD ST STE 104
Practice Address - Street 2:
Practice Address - City:LANSDALE
Practice Address - State:PA
Practice Address - Zip Code:19446-1052
Practice Address - Country:US
Practice Address - Phone:215-855-3233
Practice Address - Fax:215-855-8029
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-13
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0700XDental ProvidersDentistProsthodonticsGroup - Single Specialty