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Organization
AU DENTAL
Active
Organization
AU DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GAGAN UPPAL DMD (DENTIST/OWNER)
(215) 676-0222
Entity
Organization
Contact information
Practice address
10000 ROOSEVELT BLVD, PHILADELPHIA, PA 19116-3901
(215) 676-0222
(215) 676-0224
Mailing address
10000 ROOSEVELT BLVD, PHILADELPHIA, PA 19116-3901
(215) 676-0222
(215) 676-0224
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
DS037672
PA
Other
Enumeration date
05/08/2009
Last updated
05/08/2009
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