Organization
PIMD DENTAL
Active
Parent organization
PENN INTEGRATIVE MEDICAL & DENTAL CENTER INC.
Other names
PIMD
Organization subpart
Yes
Provider details
NPI number
Legal business name
PENN INTEGRATIVE MEDICAL & DENTAL CENTER INC.
Authorized official
MR. CHENET P. LAROSE DENTIST (DENTIST)
(786) 319-2474
Entity
Organization
Contact information
Practice address
7130 RISING SUN AVE, PHILADELPHIA, PA 19111-3957
(786) 319-2474
Mailing address
7130 RISING SUN AVE, PHILADELPHIA, PA 19111-3957
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS027302L
PA
Other
Enumeration date
09/17/2015
Last updated
09/17/2015
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