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General NPI Number Information
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NPI Number | 1841422300
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Entity Type | Organization
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Legal Business Name | YES DENTAL
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Dates
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Enumeration Date | 08/18/2009
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Last Update Date | 05/30/2013
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Provider Practice Location Address
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Address Line | 2327 COTTMAN AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19149-1008
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Country | US
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Telephone | 215-332-8700
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Fax | 215-359-0841
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Provider Business Mailing Address
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Address Line | 2327 COTTMAN AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19149-1008
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Country | US
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Telephone | 215-332-8700
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Fax | 215-359-0841
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BORIS RUBINSTEIN
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Credential | DMD
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Telephone | 215-332-8700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 54499-1
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License Number State | NY
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