| Gpha - Snyder Avenue Dental Center | |
|
640 Snyder Ave Philadelphia PA 19148-2419 | |
| (215) 334-4900 | |
| (215) 334-9721 |
| Full Name | Gpha - Snyder Avenue Dental Center |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 640 Snyder Ave, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | D Tina Smith (PROVIDER ENROLLMENT SPEC.) |
| Authorized Official Contact | 2159252400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gpha - Snyder Avenue Dental Center 1401 S 31st St 2nd Floor Philadelphia PA 19146-3506 Ph: (215) 925-2400 | Gpha - Snyder Avenue Dental Center 640 Snyder Ave Philadelphia PA 19148-2419 Ph: (215) 334-4900 |
| NPI Number | 1760709794 |
|---|---|
| Provider Enumeration Date | 04/30/2010 |
| Last Update Date | 03/15/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760709794 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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