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General NPI Number Information
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NPI Number | 1477683829
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Entity Type | Organization
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Legal Business Name | KAMINSKY DENTAL ASSOCIATES P C
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 03/09/2021
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Provider Practice Location Address
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Address Line | 1500 MARKET ST CENTRE SQUARE BUILDING, LOWER MEZZANINE, WEST TOWER
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City | PHILADELPHIA
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State | PA
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Zip | 19102-2100
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Country | US
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Telephone | 215-972-9722
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Fax | 215-972-0716
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Provider Business Mailing Address
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Address Line | 1500 MARKET ST CENTRE SQUARE BUILDING, LOWER MEZZANINE, WEST TOWER
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City | PHILADELPHIA
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State | PA
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Zip | 19102-2100
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Country | US
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Telephone | 215-972-9722
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Fax | 215-972-0716
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Authorized Official
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Title or Position | OWNER
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Name | DR. RANDE STEVEN KAMINSKY
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Credential | D.M.D.
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Telephone | 215-972-9722
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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 | DS024820L
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License Number State | PA
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