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Organization
SPECIAL SMILES LTD
Active
Organization
SPECIAL SMILES LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK S GOLDSTEIN DDS (OWNER)
(215) 707-0575
Entity
Organization
Contact information
Practice address
100 E LEHIGH AVE, PHILADELPHIA, PA 19125-1012
(215) 707-0580
(215) 707-0848
Mailing address
6404 ROOSEVELT BLVD, PHILADELPHIA, PA 19149-2943
(215) 707-0575
(215) 707-0848
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0019651990001
—
PA
Enumeration date
12/12/2006
Last updated
08/22/2020
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