Individual
DR. KANCHAN C. VAIDYA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
5635 CHESTER AVE, PHILADELPHIA, PA 19143-5346
(215) 727-1010
(215) 727-9396
Mailing address
5635 CHESTER AVE, PHILADELPHIA, PA 19143-5346
(215) 727-1010
(215) 727-9396
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DSO20414-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0005294450001
—
PA
01
—
3909
UNITED CONCORDIA CO.
PA
Enumeration date
07/16/2006
Last updated
07/09/2007
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