Organization
ISMILE DENTAL GROUP, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GRACE HARRIMAN (DIRECTOR OF BUSINESS OPERATIONS)
(267) 668-8001
Entity
Organization
Contact information
Practice address
6573 ROOSEVELT BLVD, PHILADELPHIA, PA 19149
(267) 668-8001
(267) 668-8002
Mailing address
6573 ROOSEVELT BLVD, PHILADELPHIA, PA 19149
(267) 668-8001
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
PA
1223G0001X
General Practice Dentistry
Primary
—
PA
Other
Enumeration date
07/13/2015
Last updated
03/13/2017
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