| Prodental | |
|
1335 W. Tabor Road (suite 105) (suite 105) Philadelphia PA 19141-3038 | |
| (215) 276-3369 | |
| Not Available |
| Full Name | Prodental |
|---|---|
| Speciality | Preferred Provider Organization |
| Location | 1335 W. Tabor Road (suite 105), Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Tahir Tahir Farid (FOUNDER AND CEO) |
| Authorized Official Contact | 2159648396 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Prodental 1335 W. Tabor Road (suite 105) Philadelphia PA 19141 Ph: (215) 276-3369 | Prodental 1335 W. Tabor Road (suite 105) (suite 105) Philadelphia PA 19141-3038 Ph: (215) 276-3369 |
| NPI Number | 1629469937 |
|---|---|
| Provider Enumeration Date | 02/09/2015 |
| Last Update Date | 02/11/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629469937 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Secondary |
| 305R00000X | Preferred Provider Organization | (* (Not Available)) | Primary |
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