| Smile Team Pc | |
|
9301 Banes St Philadelphia PA 19115-4201 | |
| (215) 709-0001 | |
| (215) 709-6002 |
| Full Name | Smile Team Pc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 9301 Banes St, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Bansi Doescher (OWNER) |
| Authorized Official Contact | 2157090001 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Smile Team Pc 9301 Banes St Philadelphia PA 19115-4201 Ph: (215) 709-0001 | Smile Team Pc 9301 Banes St Philadelphia PA 19115-4201 Ph: (215) 709-0001 |
| NPI Number | 1215574355 |
|---|---|
| Provider Enumeration Date | 12/09/2019 |
| Last Update Date | 12/09/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215574355 | NPI | - | NPPES |
| 1035067790001 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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