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General NPI Number Information
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NPI Number | 1831944164
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Entity Type | Organization
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Legal Business Name | TROOPER DENTAL ASSOCIATES PC
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Dates
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Enumeration Date | 04/19/2024
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Last Update Date | 04/19/2024
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Provider Practice Location Address
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Address Line | 2412 RHAWN ST
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City | PHILADELPHIA
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State | PA
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Zip | 19152-3324
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Country | US
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Telephone | 215-332-5259
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Fax |
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Provider Business Mailing Address
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Address Line | 182 VALLEY STREAM CIR
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City | CHESTERBROOK
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State | PA
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Zip | 19087-5818
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Country | US
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Telephone | 305-283-3326
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Fax |
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Authorized Official
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Title or Position | CEO/DENTIST/OWNER
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Name | KATIA C GUERRA
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Credential | DMD
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Telephone | 305-283-3326
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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 |
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License Number State |
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