Organization
PENN 1 DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. YEFIM ARANBAYEV DDS (DENTIST/PRESIDENT)
(215) 290-8230
Entity
Organization
Contact information
Practice address
1404 POINT BREEZE AVE, PHILADELPHIA, PA 19146-4522
(215) 290-8230
Mailing address
1404 POINT BREEZE AVE, PHILADELPHIA, PA 19146-4522
(215) 290-8230
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS038565
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10259118000002
—
PA
Enumeration date
01/07/2015
Last updated
01/07/2015
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