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General NPI Number Information
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NPI Number | 1932659067
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Entity Type | Organization
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Legal Business Name | CD DENTAL
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Dates
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Enumeration Date | 10/13/2016
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Last Update Date | 10/13/2016
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Provider Practice Location Address
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Address Line | 10107A VERREE RD
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City | PHILADELPHIA
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State | PA
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Zip | 19116-3613
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Country | US
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Telephone | 732-254-1994
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Fax |
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Provider Business Mailing Address
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Address Line | 10107A VERREE RD
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City | PHILADELPHIA
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State | PA
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Zip | 19116-3613
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. RUNJAN SETH
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Credential |
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Telephone | 732-254-1994
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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 | DS036386
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License Number State | PA
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