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General NPI Number Information
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NPI Number | 1073221339
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Entity Type | Organization
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Legal Business Name | TOOTH BUD PEDIATRIC DENTISTRY
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Dates
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Enumeration Date | 11/07/2022
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Last Update Date | 11/07/2022
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Provider Practice Location Address
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Address Line | 21 W HIGHLAND AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19118-3309
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Country | US
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Telephone | 215-792-7999
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Fax |
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Provider Business Mailing Address
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Address Line | 7835 BUIST AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19153-1204
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Country | US
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Telephone | 215-850-2761
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Fax |
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Authorized Official
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Title or Position | OWNER/ PEDIATRIC DENTIST
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Name | DR. YASMINA D WRIGHT
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Credential | DDS
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Telephone | 215-850-2761
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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