Healthcare Provider Details

I. General information

NPI: 1790022143
Provider Name (Legal Business Name): A PLUS PERIODONTIC SPECIALTY CARE, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2013
Last Update Date: 04/17/2021
Certification Date: 04/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

604 S WASHINGTON SQ DENTAL SUITE
PHILADELPHIA PA
19106-4118
US

IV. Provider business mailing address

401 COMMERCE DR SUITE 108
FT WASHINGTON PA
19034-2714
US

V. Phone/Fax

Practice location:
  • Phone: 215-550-4590
  • Fax: 215-646-6166
Mailing address:
  • Phone: 215-550-4590
  • Fax: 215-646-6166

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number
License Number State

VIII. Authorized Official

Name: BHASKAR SAVANI
Title or Position: OWNER
Credential:
Phone: 215-550-4590