Spark Oral Surgery Pa, Pllc
NPI #1316728652 in Hazle Township, Pennsylvania
Provider Information
- NPI Number
- 1316728652
- Entity Type
- Organization
- Organization Name
- Spark Oral Surgery Pa, Pllc
- Primary Specialty
- Dentist - Oral and Maxillofacial Surgery
- Enumeration Date
- Oct 12, 2023
- Last Updated
- Aug 15, 2024
Practice Location
- Address
- 330 LAUREL MALL
- City
- Hazle Township
- State
- Pennsylvania
- ZIP Code
- 18202-1205
- Phone
- (610) 223-7777
Authorized Official
- Name
- PHI LE
- Title
- GENERAL COUNSEL
- Phone
- (267) 575-2321
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - Oral and Maxillofacial Surgery — Oral and Maxillofacial Surgery |
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