Bala Oral Health Center | |
125 W City Avenue Bala Cynwyd PA 19004 | |
(610) 667-7171 | |
(610) 667-5121 |
Full Name | Bala Oral Health Center |
---|---|
Speciality | Dentist |
Location | 125 W City Avenue, Bala Cynwyd, Pennsylvania |
Authorized Official Name and Position | Bahman Sani Khatam (OWNER) |
Authorized Official Contact | 6106677171 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Bala Oral Health Center 125 W City Avenue Bala Cynwyd PA 19004 Ph: (610) 667-7171 | Bala Oral Health Center 125 W City Avenue Bala Cynwyd PA 19004 Ph: (610) 667-7171 |
NPI Number | 1174680961 |
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Provider Enumeration Date | 01/02/2007 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1174680961 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | DS024444L (Pennsylvania) | Primary |
122300000X | Dentist | DS026658L (Pennsylvania) | Secondary |
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