| Passyunk Dental Group | |
|
1507 W Passyunk Ave Philadelphia PA 19145-3029 | |
| (215) 372-0060 | |
| Not Available |
| Full Name | Passyunk Dental Group |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1507 W Passyunk Ave, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Michael Imad Alharir (PRESIDENT) |
| Authorized Official Contact | 9013190222 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Passyunk Dental Group 1507 W Passyunk Ave Philadelphia PA 19145-3029 Ph: () - | Passyunk Dental Group 1507 W Passyunk Ave Philadelphia PA 19145-3029 Ph: (215) 372-0060 |
| NPI Number | 1346764214 |
|---|---|
| Provider Enumeration Date | 08/01/2017 |
| Last Update Date | 08/01/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346764214 | NPI | - | NPPES |
| 1063893071 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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