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General NPI Number Information
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NPI Number | 1629469937
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Entity Type | Organization
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Legal Business Name | AFFORDABLE DENTISTRY OF NORTH PHILADELPHIA .INC
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Dates
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Enumeration Date | 02/09/2015
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Last Update Date | 02/11/2015
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Provider Practice Location Address
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Address Line | 1335 W. TABOR ROAD (SUITE 105) (SUITE 105)
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City | PHILADELPHIA
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State | PA
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Zip | 19141-3038
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Country | US
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Telephone | 215-276-3369
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Fax |
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Provider Business Mailing Address
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Address Line | 1335 W. TABOR ROAD (SUITE 105)
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City | PHILADELPHIA
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State | PA
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Zip | 19141
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Country | US
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Telephone | 215-276-3369
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Fax |
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Authorized Official
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Title or Position | FOUNDER AND CEO
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Name | MR. TAHIR TAHIR FARID
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Credential |
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Telephone | 215-964-8396
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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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Taxonomy #2
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number |
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License Number State |
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