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General NPI Number Information
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NPI Number | 1770755944
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Entity Type | Organization
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Legal Business Name | AMJAD DENTAL ASSOCIATES INC
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Dates
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Enumeration Date | 03/28/2008
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Last Update Date | 06/26/2008
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Provider Practice Location Address
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Address Line | 500B E GODFREY AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19120-2117
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Country | US
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Telephone | 215-745-9100
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Fax |
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Provider Business Mailing Address
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Address Line | 500-B E GODFREY AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19120-2129
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Country | US
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Telephone | 215-745-9100
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. THERESA MARTINEZ
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Credential |
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Telephone | 215-745-9100
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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 | 020822
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License Number State | PA
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