Organization
PRESTIGE DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KATHLEEN WU DMD (OWNER)
(267) 202-0083
Entity
Organization
Contact information
Practice address
246 W GIRARD AVE, PHILADELPHIA, PA 19123-1538
(267) 202-0083
Mailing address
246 W GIRARD AVE, PHILADELPHIA, PA 19123-1538
(267) 202-0083
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
DS030683L
PA
Other
Enumeration date
10/16/2013
Last updated
10/16/2013
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