Organization
MAIN STREET DENTAL CENTER CITY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD VICTOR EIDELSON DDS, FAGD (PRESIDENT DENTIST)
(215) 627-1995
Entity
Organization
Contact information
Practice address
1048 SOUTH ST, PHILADELPHIA, PA 19147-1935
(215) 627-1995
(215) 627-1999
Mailing address
1048 SOUTH ST, PHILADELPHIA, PA 19147-1935
(215) 627-1995
(215) 627-1999
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS019673L
PA
Other
Enumeration date
05/29/2007
Last updated
04/22/2011
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