| Park Avenue Dental Associates | |
|
134 S State Rd Upper Darby PA 19082-2902 | |
| (610) 789-2440 | |
| (610) 789-2442 |
| Full Name | Park Avenue Dental Associates |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 134 S State Rd, Upper Darby, Pennsylvania |
| Authorized Official Name and Position | Said Hussien Mohamed-ai (OWNER) |
| Authorized Official Contact | 6107892440 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Park Avenue Dental Associates 134 S State Rd Upper Darby PA 19082-2902 Ph: (610) 789-2440 | Park Avenue Dental Associates 134 S State Rd Upper Darby PA 19082-2902 Ph: (610) 789-2440 |
| NPI Number | 1689732380 |
|---|---|
| Provider Enumeration Date | 12/05/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689732380 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DS020611L (Pennsylvania) | Primary |
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Rachel J. Mallya, D.m.d., P.c Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 27 Garrett Rd, Upper Darby, PA 19082 Phone: 610-352-7766 Fax: 610-352-6626 | |
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