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General NPI Number Information
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NPI Number | 1124642897
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Entity Type | Organization
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Legal Business Name | WALNUT STREET SMILES PC
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Dates
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Enumeration Date | 05/29/2020
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Last Update Date | 05/29/2020
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Provider Practice Location Address
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Address Line | 1601 WALNUT ST STE 1025
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City | PHILADELPHIA
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State | PA
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Zip | 19102-2911
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Country | US
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Telephone | 215-564-1025
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Fax | 215-564-1027
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Provider Business Mailing Address
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Address Line | 1601 WALNUT ST STE 1025
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City | PHILADELPHIA
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State | PA
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Zip | 19102-2911
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Country | US
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Telephone | 215-564-1025
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Fax |
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | MS. BARBARA HAMILTON SCHREINER
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Credential |
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Telephone | 484-804-3738
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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