| Kids Smiles | |
|
5828 Market St # B Philadelphia PA 19139-3114 | |
| (215) 747-6901 | |
| (215) 747-6907 |
| Full Name | Kids Smiles |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 5828 Market St # B, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Noni Mastra (FINANCIAL DIRECTOR) |
| Authorized Official Contact | 2157476901 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kids Smiles 5828 Market St # B Philadelphia PA 19139-3114 Ph: (215) 747-6901 | Kids Smiles 5828 Market St # B Philadelphia PA 19139-3114 Ph: (215) 747-6901 |
| NPI Number | 1851432298 |
|---|---|
| Provider Enumeration Date | 02/09/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851432298 | NPI | - | NPPES |
| 0018280190002 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DS021445L (Pennsylvania) | Primary |
| 1223G0001X | Dentist - General Practice | DS036815 (Pennsylvania) | Secondary |
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