Organization
5TH STREET DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. P TRIVEDI (OWNER)
(215) 333-6825
Entity
Organization
Contact information
Practice address
2822 N 5TH ST, PHILADELPHIA, PA 19133-2712
(215) 333-6825
(215) 335-4340
Mailing address
2822 N 5TH ST, PHILADELPHIA, PA 19133-2712
(215) 333-6825
(215) 335-4340
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
08/10/2011
Last updated
08/10/2011
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