Penn 1 Dental | |
1404 Point Breeze Ave Philadelphia PA 19146-4522 | |
(215) 290-8230 | |
Not Available |
Full Name | Penn 1 Dental |
---|---|
Speciality | Dentist - General Practice |
Location | 1404 Point Breeze Ave, Philadelphia, Pennsylvania |
Authorized Official Name and Position | Yefim Aranbayev (DENTIST/PRESIDENT) |
Authorized Official Contact | 2152908230 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Penn 1 Dental 1404 Point Breeze Ave Philadelphia PA 19146-4522 Ph: (215) 290-8230 | Penn 1 Dental 1404 Point Breeze Ave Philadelphia PA 19146-4522 Ph: (215) 290-8230 |
NPI Number | 1003204553 |
---|---|
Provider Enumeration Date | 01/07/2015 |
Last Update Date | 01/07/2015 |
Identifier | Type | State | Issuer |
---|---|---|---|
1003204553 | NPI | - | NPPES |
10259118000002 | Medicaid | PA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | DS038565 (Pennsylvania) | Primary |
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