| Special Smiles Ltd | |
|
100 E Lehigh Ave Philadelphia PA 19125-1012 | |
| (215) 707-0580 | |
| (215) 707-0848 |
| Full Name | Special Smiles Ltd |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 100 E Lehigh Ave, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Mark S Goldstein (OWNER) |
| Authorized Official Contact | 2157070575 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Special Smiles Ltd 6404 Roosevelt Blvd Philadelphia PA 19149-2943 Ph: (215) 707-0575 | Special Smiles Ltd 100 E Lehigh Ave Philadelphia PA 19125-1012 Ph: (215) 707-0580 |
| NPI Number | 1639239296 |
|---|---|
| Provider Enumeration Date | 12/12/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639239296 | NPI | - | NPPES |
| 0019651990001 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (Pennsylvania) | Primary |
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