=====================================================
General NPI Number Information
=====================================================
NPI Number | 1770911018
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PARVEEN SULTANA DMD PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/24/2013
-----------------------------------------------------
Last Update Date | 10/24/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 155 LITTLE CONESTOGA RD
-----------------------------------------------------
City | CHESTER SPRINGS
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19425-9562
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 484-348-1800
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 155 LITTLE CONESTOGA RD
-----------------------------------------------------
City | CHESTER SPRINGS
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19425-9562
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 484-348-1800
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DENTIST
-----------------------------------------------------
Name | DR. PARVEEN SULTANA
-----------------------------------------------------
Credential | DMD
-----------------------------------------------------
Telephone | 484-348-1800
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 122300000X
-----------------------------------------------------
Taxonomy Name | Dentist
-----------------------------------------------------
License Number | DS038274
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------