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General NPI Number Information
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NPI Number | 1457525214
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Entity Type | Organization
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Legal Business Name | PRINCE OFOSU-MENSAH, DMD, PC.
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Dates
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Enumeration Date | 04/14/2008
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Last Update Date | 04/14/2008
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Provider Practice Location Address
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Address Line | 1619 GRANT AVE SUITE 23
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City | PHILADELPHIA
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State | PA
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Zip | 19115-3167
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Country | US
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Telephone | 215-673-4940
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Fax |
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Provider Business Mailing Address
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Address Line | 4216 LORING ST
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City | PHILADELPHIA
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State | PA
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Zip | 19136-3917
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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 | PRESIDENT
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Name | PRINCE OFOSU-MENSAH
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Credential | DMD
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Telephone | 215-673-4940
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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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