# AU DENTAL

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

## Provider details

- **NPI number:** 1538393392
- **Authorized official:** GAGAN UPPAL DMD (DENTIST/OWNER)
- **Authorized official phone:** (215) 676-0222

## Contact information

- **Practice address:** 10000 ROOSEVELT BLVD, PHILADELPHIA, PA 19116-3901
- **Practice address phone:** (215) 676-0222
- **Practice address fax:** (215) 676-0224
- **Mailing address:** 10000 ROOSEVELT BLVD, PHILADELPHIA, PA 19116-3901
- **Mailing address phone:** (215) 676-0222
- **Mailing address fax:** (215) 676-0224

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | DS037672 | PA | Yes |

## Other

- **Enumeration date:** 05/08/2009
- **Last updated:** 05/08/2009