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General NPI Number Information
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NPI Number | 1659051803
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Entity Type | Individual
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Provider Name | PARAS KUMAR GUPTA DMD
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Gender | Male
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Dates
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Enumeration Date | 07/24/2023
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Last Update Date | 07/24/2023
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Provider Practice Location Address
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Address Line | 3223 N BROAD ST
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City | PHILADELPHIA
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State | PA
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Zip | 19140-5007
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Country | US
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Telephone | 559-967-3763
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Fax |
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Provider Business Mailing Address
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Address Line | 450 N 18TH ST APT 1645
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City | PHILADELPHIA
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State | PA
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Zip | 19130-4232
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Country | US
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Telephone | 559-967-3763
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DS044214
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License Number State | PA
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