# PHILADELPHIA DENTAL COSMETICS

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PHILADELPHIA DENTAL COSMETICS
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1770110272
- **Legal business name:** PHILADELPHIA DENTAL COSMETICS
- **Authorized official:** JAY J LIU DMD, FICOI (OWNER (SELF))
- **Authorized official phone:** (267) 250-8082

## Contact information

- **Practice address:** 1601 WALNUT ST, SUITE 822, PHILADELPHIA, PA 19102
- **Practice address phone:** (215) 557-7979
- **Practice address fax:** (215) 557-7930
- **Mailing address:** 1601 WALNUT ST, SUITE 822, PHILADELPHIA, PA 19102
- **Mailing address phone:** (215) 557-7979
- **Mailing address fax:** (215) 557-7930

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 03/25/2020
- **Last updated:** 03/25/2020