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General NPI Number Information
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NPI Number | 1922655018
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Entity Type | Individual
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Provider Name | RANIA EL MADHOUN DMD
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Gender | Female
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Dates
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Enumeration Date | 08/22/2019
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Last Update Date | 08/22/2019
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Provider Practice Location Address
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Address Line | 2200 ARCH ST STE 102
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City | PHILADELPHIA
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State | PA
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Zip | 19103-1353
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Country | US
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Telephone | 610-220-7052
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Fax |
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Provider Business Mailing Address
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Address Line | 200 N 16TH ST APT 804
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City | PHILADELPHIA
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State | PA
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Zip | 19102-1221
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Country | US
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Telephone | 770-910-0989
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | DS042423
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License Number State | PA
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