Individual
DR. PAUL THOMAS FORTANASCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
400 MCFARLAN RD STE 200, KENNETT SQUARE, PA 19348-2477
(610) 925-5700
Mailing address
400 MCFARLAN RD STE 200, KENNETT SQUARE, PA 19348-2477
(516) 330-4354
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DS041759
PA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
02/01/2018
Last updated
11/03/2020
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