Organization
DENTAL WIZARD G PC
Active
Other names
Diamante Dental, Paradise Dental
Organization subpart
No
Provider details
NPI number
Authorized official
OLEG GENIS DMD (OWNER)
(267) 886-9474
Entity
Organization
Contact information
Practice address
2338 N FRONT ST, PHILADELPHIA, PA 19133-3716
(267) 886-9474
Mailing address
2338 N FRONT ST, PHILADELPHIA, PA 19133-3716
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
01/12/2018
Last updated
06/16/2018
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