Organization
ELENA M KOFMAN DMD PC
Active
Other names
Family Dental Group
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELENA M KOFMAN DMD (OWNER/DENTIST)
(610) 692-1808
Entity
Organization
Contact information
Practice address
1599 PAOLI PIKE, WEST CHESTER, PA 19380-6113
(610) 692-1808
(610) 692-0509
Mailing address
1599 PAOLI PIKE, WEST CHESTER, PA 19380-6113
(610) 692-1808
(610) 692-0509
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
DS035176
PA
1223G0001X
General Practice Dentistry
Primary
DS29460L
PA
1223P0300X
Periodontics
DS036330
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
134197
UNITED CONCORDIA
PA
Enumeration date
07/23/2009
Last updated
07/23/2009
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