Provider Demographics
NPI:1881113256
Name:MEMAR DENTAL CARE, LLC
Entity type:Organization
Organization Name:MEMAR DENTAL CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:OQBA
Authorized Official - Middle Name:
Authorized Official - Last Name:MEMAR
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:610-325-4444
Mailing Address - Street 1:1999 SPROUL RD STE 15
Mailing Address - Street 2:
Mailing Address - City:BROOMALL
Mailing Address - State:PA
Mailing Address - Zip Code:19008-3508
Mailing Address - Country:US
Mailing Address - Phone:610-325-4444
Mailing Address - Fax:
Practice Address - Street 1:1999 SPROUL RD STE 15
Practice Address - Street 2:
Practice Address - City:BROOMALL
Practice Address - State:PA
Practice Address - Zip Code:19008-3508
Practice Address - Country:US
Practice Address - Phone:610-325-4444
Practice Address - Fax:610-325-6993
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-16
Last Update Date:2023-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS039575261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental