Organization
OUTSIDE BONES PC
Active
Other names
Complete Care Dental
Organization subpart
No
Provider details
NPI number
Authorized official
JORDAN KLINKNER (OWNER)
(608) 697-3087
Entity
Organization
Contact information
Practice address
1300 MACDADE BLVD UNIT 5, WOODLYN, PA 19094-1500
(608) 697-3087
Mailing address
1411 EMERICK ST, PHILADELPHIA, PA 19125-2612
(917) 523-9800
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
11/21/2019
Last updated
01/21/2020
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