| Gallery Mall Dental Pc | |
|
901 Market St Space 3220 Gallery Mall One Philadelphia PA 19107 | |
| (215) 627-4290 | |
| (215) 627-4293 |
| Full Name | Gallery Mall Dental Pc |
|---|---|
| Speciality | Dentist |
| Location | 901 Market St, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Prolay Kumar Paul (PARTNER) |
| Authorized Official Contact | 2156274290 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gallery Mall Dental Pc 901 Market St Space 3220 Philadelphia PA 19107 Ph: (215) 627-4290 | Gallery Mall Dental Pc 901 Market St Space 3220 Gallery Mall One Philadelphia PA 19107 Ph: (215) 627-4290 |
| NPI Number | 1902051535 |
|---|---|
| Provider Enumeration Date | 11/24/2008 |
| Last Update Date | 12/18/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902051535 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DS037098 (Pennsylvania) | Primary |
| 122300000X | Dentist | DS037088 (Pennsylvania) | Secondary |
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Secondary |
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