Organization
PROSPECT PARK FAMILY DENTISTRY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KETAV SHAH (OWNER)
(610) 583-5052
Entity
Organization
Contact information
Practice address
907 LINCOLN AVE, PROSPECT PARK, PA 19076-1414
(610) 583-5052
Mailing address
907 LINCOLN AVE, PROSPECT PARK, PA 19076-1414
(610) 583-5052
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
12/20/2023
Last updated
12/20/2023
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