# PENN 1 DENTAL

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003204553
- **Authorized official:** DR. YEFIM ARANBAYEV DDS (DENTIST/PRESIDENT)
- **Authorized official phone:** (215) 290-8230

## Contact information

- **Practice address:** 1404 POINT BREEZE AVE, PHILADELPHIA, PA 19146-4522
- **Practice address phone:** (215) 290-8230
- **Mailing address:** 1404 POINT BREEZE AVE, PHILADELPHIA, PA 19146-4522
- **Mailing address phone:** (215) 290-8230

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | DS038565 | PA | Yes |

## Other

- **Enumeration date:** 01/07/2015
- **Last updated:** 01/07/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 10259118000002 | — | PA |