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General NPI Number Information
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NPI Number | 1134944960
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Entity Type | Organization
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Legal Business Name | DENTAL IMPLANT SPECIALISTS OF PENNSYLVANIA II, PC
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Dates
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Enumeration Date | 11/18/2024
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Last Update Date | 11/18/2024
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Provider Practice Location Address
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Address Line | 1601 WALNUT ST STE 1217
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City | PHILADELPHIA
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State | PA
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Zip | 19102-2908
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Country | US
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Telephone | 215-575-0550
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Fax |
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Provider Business Mailing Address
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Address Line | 3500 MAPLE AVE STE 1600
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City | DALLAS
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State | TX
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Zip | 75219-3936
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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 | PROVIDER PARTNER
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Name | RIAD ALMASRI
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Credential |
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Telephone | 469-688-5555
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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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