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General NPI Number Information
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NPI Number | 1033558572
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Entity Type | Organization
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Legal Business Name | ALLCARE DENTAL GROUP LLC
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Dates
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Enumeration Date | 06/18/2013
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Last Update Date | 10/02/2013
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Provider Practice Location Address
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Address Line | 3635 GERMANTOWN AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19140-4255
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Country | US
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Telephone | 215-907-7300
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Fax | 215-827-5741
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Provider Business Mailing Address
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Address Line | 3635 GERMANTOWN AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19140-4255
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Country | US
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Telephone | 215-907-7300
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Fax | 215-827-5741
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Authorized Official
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Title or Position | GENERAL MANAGER
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Name | MR. SERGE VSEBLUSKY
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Credential |
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Telephone | 215-907-7300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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