Organization
SPECIALTY MANAGEMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SOPHIA AVANZATO (PRESIDENT/CEO)
(484) 432-2737
Entity
Organization
Contact information
Practice address
626 SNYDER AVE, SUITE 200, PHILADELPHIA, PA 19148-2419
(267) 940-0300
Mailing address
626 SNYDER AVE, SUITE 200, PHILADELPHIA, PA 19148-2419
(267) 940-0300
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
03/19/2008
Last updated
03/19/2008
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