# CAMPUS DENTAL CENTER, INC.

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

## Provider details

- **NPI number:** 1538234018
- **Authorized official:** DR. SAID H. MOHAMED-ALI D.D.S. (OWNER)
- **Authorized official phone:** (610) 872-2355

## Contact information

- **Practice address:** 2200 PROVIDENCE AVE, CHESTER, PA 19013-5219
- **Practice address phone:** (610) 872-2355
- **Practice address fax:** (610) 872-1924
- **Mailing address:** 2200 PROVIDENCE AVE, CHESTER, PA 19013-5219
- **Mailing address phone:** (610) 872-2355
- **Mailing address fax:** (610) 872-1924

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | DS020611L | PA | Yes |

## Other

- **Enumeration date:** 11/21/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0005296320001 | — | PA |