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General NPI Number Information
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NPI Number | 1497265649
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Entity Type | Organization
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Legal Business Name | VIP DENTAL CARE, LLC
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Dates
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Enumeration Date | 10/02/2017
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Last Update Date | 02/08/2024
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Provider Practice Location Address
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Address Line | 5620 N 5TH ST
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City | PHILADELPHIA
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State | PA
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Zip | 19120-2306
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Country | US
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Telephone | 215-650-7313
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Fax | 215-695-5511
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Provider Business Mailing Address
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Address Line | 1535 SWEETBRIAR DR
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City | JAMISON
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State | PA
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Zip | 18929-1653
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Country | US
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Telephone | 215-275-6313
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Fax | 267-368-6581
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Authorized Official
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Title or Position | PRINCIPLE
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Name | MR. YEFIM KANDOV
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Credential |
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Telephone | 215-275-6313
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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