# PATELKA DENTAL ON WHEELS

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

## Provider details

- **NPI number:** 1386992873
- **Authorized official:** MRS. SVETLANA KUTOVOY (OWNER)
- **Authorized official phone:** (215) 342-5090

## Contact information

- **Practice address:** 8332 BUSTLETON AVE, UNIT B, PHILADELPHIA, PA 19152-1909
- **Practice address phone:** (215) 342-5090
- **Mailing address:** PO BOX 51027, PHILADELPHIA, PA 19115-0027
- **Mailing address phone:** (215) 342-5090

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | DS020408L | PA | Yes |

## Other

- **Enumeration date:** 08/15/2012
- **Last updated:** 08/15/2012