Individual
KAAENAAT MUSTAFA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2301 E ALLEGHENY AVE, PHILADELPHIA, PA 19134-4427
(919) 802-2148
Mailing address
228 BILLINGRATH TURN LN, CARY, NC 27519-2908
(919) 802-2148
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DS043566
PA
1223D0001X
Public Health Dentistry
10915
NC
1223G0001X
General Practice Dentistry
10915
NC
1223P0221X
Pediatric Dentistry
Primary
10915
NC
Other
Enumeration date
04/04/2017
Last updated
06/26/2024
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