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General NPI Number Information
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NPI Number | 1457799165
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Entity Type | Individual
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Provider Name | ROSS ANDREW LEVINE D.M.D
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Gender | Male
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Dates
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Enumeration Date | 06/05/2013
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Last Update Date | 06/05/2013
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Provider Practice Location Address
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Address Line | 100 E. LEHIGH AVE PEDATRIC DENTAL ASSOCIATES
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City | PHILADELPHIA
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State | PA
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Zip | 19125
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Country | US
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Telephone | 215-913-4427
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Fax |
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Provider Business Mailing Address
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Address Line | 88 BOBBIE DR
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City | IVYLAND
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State | PA
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Zip | 18974-1600
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Country | US
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Telephone | 215-913-4427
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | DS039502
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License Number State | PA
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