Organization
MDS MANAGEMENT, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NATALYA KONDRATYEVA D.D.S. (OWNER)
(856) 963-0315
Entity
Organization
Contact information
Practice address
433 MARKET ST STE 102, CAMDEN, NJ 08102-1572
(856) 963-0315
(856) 963-2369
Mailing address
352 2ND STREET PIKE #396, SOUTHAMPTON, PA 18966
(215) 745-5734
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS 029186-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100963871-0001
—
PA
01
—
864628
UNITED CONCORDIA GROUP ID
PA
Enumeration date
01/24/2007
Last updated
01/19/2021
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