Organization
MODERN DENTISTRY AND COSMETOLOGY CENTER
Active
Other names
Modern Dentistry and Cosmetology Center PC
Organization subpart
No
Provider details
NPI number
Authorized official
IRINA STEPANSKY DMD (OWNER)
(215) 676-9050
Entity
Organization
Contact information
Practice address
11911 BUSTLETON AVE, PHILADELPHIA, PA 19116-2541
(215) 673-9050
Mailing address
11911 BUSTLETON AVE, PHILADELPHIA, PA 19116-2541
(215) 673-9050
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
261Q00000X
Clinic/Center
—
—
261QD0000X
Dental Clinic/Center
—
—
Other
Enumeration date
03/17/2020
Last updated
03/17/2020
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