| Smile For Life Pc | |
|
9173 Roosevelt Blvd Spc 22 Philadelphia PA 19114-2204 | |
| (215) 515-4797 | |
| Not Available |
| Full Name | Smile For Life Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 9173 Roosevelt Blvd Spc 22, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Nino Taboridze (MANAGER) |
| Authorized Official Contact | 2155529800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Smile For Life Pc 9173 Roosevelt Blvd Spc 22 Philadelphia PA 19114-2204 Ph: (215) 515-4797 | Smile For Life Pc 9173 Roosevelt Blvd Spc 22 Philadelphia PA 19114-2204 Ph: (215) 515-4797 |
| NPI Number | 1902459902 |
|---|---|
| Provider Enumeration Date | 07/18/2019 |
| Last Update Date | 08/07/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902459902 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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