# PIMD DENTAL

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PENN INTEGRATIVE MEDICAL & DENTAL CENTER INC.
- **Other names:** PIMD
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1326417551
- **Legal business name:** PENN INTEGRATIVE MEDICAL & DENTAL CENTER INC.
- **Authorized official:** MR. CHENET P. LAROSE DENTIST (DENTIST)
- **Authorized official phone:** (786) 319-2474

## Contact information

- **Practice address:** 7130 RISING SUN AVE, PHILADELPHIA, PA 19111-3957
- **Practice address phone:** (786) 319-2474
- **Mailing address:** 7130 RISING SUN AVE, PHILADELPHIA, PA 19111-3957

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | DS027302L | PA | Yes |

## Other

- **Enumeration date:** 09/17/2015
- **Last updated:** 09/17/2015