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600 Haverford Rd Ste 202 Haverford PA 19041-1139 | |
| (610) 642-3009 | |
| (610) 642-2328 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 600 Haverford Rd Ste 202, Haverford, Pennsylvania |
| Authorized Official Name and Position | George A Souliman (MEMBER) |
| Authorized Official Contact | 8483335550 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
600 Haverford Rd Ste 202 Haverford PA 19041-1139 Ph: (610) 642-3009 | 600 Haverford Rd Ste 202 Haverford PA 19041-1139 Ph: (610) 642-3009 |
| NPI Number | 1932604089 |
|---|---|
| Provider Enumeration Date | 03/29/2018 |
| Last Update Date | 07/29/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932604089 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | DS039840 (Pennsylvania) | Primary |
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