Organization
DENTI DENTAL,INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IRINA STEPANSKY (DENTIST)
(267) 467-0265
Entity
Organization
Contact information
Practice address
3609 GERMANTOWN AVE, PHILADELPHIA, PA 19140-4225
(215) 673-9050
Mailing address
3609 GERMANTOWN AVE, PHILADELPHIA, PA 19140-4225
(215) 673-9050
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS029548L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0015576780001
—
PA
Enumeration date
08/13/2014
Last updated
08/13/2014
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