Individual
DR. PAVITHRA BALASUBRAMANIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.M.D
Contact information
Practice address
248 S 21ST ST, PHILADELPHIA, PA 19103-5000
(215) 732-3350
Mailing address
633 W RITTENHOUSE ST, APT# 226 B, PHILADELPHIA, PA 19144-4300
(412) 874-2129
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS040462
PA
Other
Enumeration date
06/24/2015
Last updated
06/24/2015
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