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General NPI Number Information
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NPI Number | 1053764209
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Entity Type | Organization
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Legal Business Name | DR ELAYNE SMITHEN RAMOS, DMD, PC
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Dates
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Enumeration Date | 07/22/2016
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Last Update Date | 07/22/2016
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Provider Practice Location Address
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Address Line | 6227 RISING SUN AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19111-5645
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Country | US
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Telephone | 215-742-4999
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Fax | 267-388-8882
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Provider Business Mailing Address
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Address Line | 6227 RISING SUN AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19111-5645
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Country | US
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Telephone | 215-742-4999
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Fax | 267-388-8882
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Authorized Official
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Title or Position | OWNER
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Name | DR. ELAYNE SMITHEN RAMOS
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Credential |
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Telephone | 215-742-4999
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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 | DS038731
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License Number State | PA
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