Provider Demographics
NPI:1699242024
Name:MICHAEL S AYES DDS AND ASSOCIATES PENNSYLVANIA VI, PC
Entity type:Organization
Organization Name:MICHAEL S AYES DDS AND ASSOCIATES PENNSYLVANIA VI, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:DEBRA
Authorized Official - Last Name:BAALS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-381-7196
Mailing Address - Street 1:630 W GERMANTOWN PIKE STE 120
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH MEETING
Mailing Address - State:PA
Mailing Address - Zip Code:19462-1074
Mailing Address - Country:US
Mailing Address - Phone:484-455-4550
Mailing Address - Fax:
Practice Address - Street 1:70 BUCKWALTER RD STE 309
Practice Address - Street 2:
Practice Address - City:ROYERSFORD
Practice Address - State:PA
Practice Address - Zip Code:19468-1846
Practice Address - Country:US
Practice Address - Phone:484-369-8629
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-24
Last Update Date:2018-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty