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Organization
IDENTAL, PC
Active
Organization
IDENTAL, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ZALIYA AKBASHEVA (OWNER)
(267) 262-2834
Entity
Organization
Contact information
Practice address
2601 E ALLEGHENY AVE, PHILADELPHIA, PA 19134-5103
(267) 262-2834
Mailing address
2601 E ALLEGHENY AVE, PHILADELPHIA, PA 19134-5103
(267) 262-2834
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS037477
PA
Other
Enumeration date
06/11/2015
Last updated
06/11/2015
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