Organization
FA5 ASSOCIATES LLC
Active
Other names
Navy Yard Dental Associates
Organization subpart
No
Provider details
NPI number
Authorized official
JOYCE LYNN RICKS (CREDENTIALING)
(610) 803-3745
Entity
Organization
Contact information
Practice address
1 CRESCENT DR STE 300, PHILADELPHIA, PA 19112-1015
(215) 389-3161
(215) 389-1036
Mailing address
9 HERALD PL, ASTON, PA 19014-2103
(610) 803-3745
(215) 389-1036
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
—
—
Other
Enumeration date
06/26/2024
Last updated
06/26/2024
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