| None | |
|
8462 Jackson St Fl 2 Philadelphia PA 19136-2428 | |
| (267) 394-1416 | |
| Not Available |
| Full Name | None |
|---|---|
| Speciality | Dentist |
| Location | 8462 Jackson St Fl 2, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Samantha J Donmez (OWNER) |
| Authorized Official Contact | 2673941416 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| None 3200 Frankford Ave # 2 Philadelphia PA 19134-3217 Ph: (215) 739-5600 | None 8462 Jackson St Fl 2 Philadelphia PA 19136-2428 Ph: (267) 394-1416 |
| NPI Number | 1952771040 |
|---|---|
| Provider Enumeration Date | 10/01/2015 |
| Last Update Date | 10/01/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952771040 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (Pennsylvania) | Primary |
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