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Organization
MODERN DENTISTRY AND COSMETOLOGY CENTER
Active
Organization
MODERN DENTISTRY AND COSMETOLOGY CENTER
Active
Other names
Modern Dentistry and Cosmetology Center PC
Organization subpart
No
Provider details
NPI number
Authorized official
IRINA STEPANSKY DMD (OWNER)
(215) 676-9050
Entity
Organization
Contact information
Practice address
11911 BUSTLETON AVE, PHILADELPHIA, PA 19116-2541
(215) 673-9050
Mailing address
11911 BUSTLETON AVE, PHILADELPHIA, PA 19116-2541
(215) 673-9050
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
NULL
1223G0001X
General Practice Dentistry
Primary
—
—
261Q00000X
Clinic/Center
—
NULL
261QD0000X
Dental Clinic/Center
—
NULL
Other
Enumeration date
03/17/2020
Last updated
03/17/2020
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