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Organization
PATELKA DENTAL ON WHEELS
Active
Organization
PATELKA DENTAL ON WHEELS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SVETLANA KUTOVOY (OWNER)
(215) 342-5090
Entity
Organization
Contact information
Practice address
8332 BUSTLETON AVE, UNIT B, PHILADELPHIA, PA 19152-1909
(215) 342-5090
Mailing address
PO BOX 51027, PHILADELPHIA, PA 19115-0027
(215) 342-5090
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
DS020408L
PA
Other
Enumeration date
08/15/2012
Last updated
08/15/2012
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