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General NPI Number Information
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NPI Number | 1275832743
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Entity Type | Organization
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Legal Business Name | PARVEENSULTANADMDPC
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Dates
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Enumeration Date | 03/22/2011
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Last Update Date | 03/22/2011
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Provider Practice Location Address
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Address Line | 2919 N 22ND ST
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City | PHILADELPHIA
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State | PA
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Zip | 19132-1505
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Country | US
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Telephone | 518-534-2855
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Fax |
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Provider Business Mailing Address
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Address Line | 275 S BRYN MAWR AVE APT A19
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City | BRYN MAWR
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State | PA
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Zip | 19010-4202
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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 | PARVEEN SULTANA
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Credential | DMD
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Telephone | 518-534-2855
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DS038274
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License Number State | PA
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