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General NPI Number Information
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NPI Number | 1073998282
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Entity Type | Organization
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Legal Business Name | PATELKA DENTAL MANAGEMENT AT FRANKFORD
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Dates
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Enumeration Date | 07/29/2015
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Last Update Date | 05/24/2016
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Provider Practice Location Address
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Address Line | 8037 FRANKFORD AVE 2ND FLOOR
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City | PHILA
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State | PA
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Zip | 19136-2756
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Country | US
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Telephone | 215-338-5454
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 6104
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City | PHILA
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State | PA
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Zip | 19115-6104
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | RASIK G PATEL
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Credential |
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Telephone | 215-338-5454
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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 | DS020408L
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License Number State | PA
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