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NPI Code Detail

MEDICARE: DR. PRINCE OFOSU-MENSAH DMD

MEDICARE: DR. PRINCE OFOSU-MENSAH DMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice DentistryDS037177PA

General Provider Information

NPI Number : 1568650166
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PRINCE OFOSU-MENSAH DMD
Provider Business Mailing Address
First Line : 432 N 6TH ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19123-4004
Country : US
Telephone Number : 215-925-2400
Fax Number : 215-925-9162
Provider Business Practice Location Address
First Line : 640 SNYDER AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19148-2419
Country : US
Telephone Number : 215-334-4900
Fax Number : 215-334-9721
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/09/2007
Last Update Date : 04/04/2016

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