Healthcare Provider Details

I. General information

NPI: 1619609815
Provider Name (Legal Business Name): RANA KHALIL RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2022
Last Update Date: 06/27/2022
Certification Date: 06/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

351 W SCHUYLKILL RD STE G-15A
POTTSTOWN PA
19465-7438
US

IV. Provider business mailing address

351 W SCHUYLKILL RD STE G-15A
POTTSTOWN PA
19465-7438
US

V. Phone/Fax

Practice location:
  • Phone: 610-326-9460
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License NumberDH070327
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License NumberPHDH001274
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: