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General NPI Number Information
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NPI Number | 1891110367
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Entity Type | Organization
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Legal Business Name | CHESTNUT HILL DENTAL CARE
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Dates
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Enumeration Date | 02/20/2014
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Last Update Date | 01/26/2016
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Provider Practice Location Address
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Address Line | 9 E HIGHLAND AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19118-3307
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Country | US
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Telephone | 215-247-4660
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Fax | 215-248-5739
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Provider Business Mailing Address
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Address Line | 9 E HIGHLAND AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19118-3307
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Country | US
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Telephone | 215-247-4660
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Fax | 215-248-5739
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Authorized Official
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Title or Position | ASSOCIATE
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Name | DR. PALAK JAIN
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Credential |
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Telephone | 215-247-4660
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | DS039804
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License Number State | PA
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