Organization
WHITE WILLOW DENTAL ARTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAOLA BUKOVCAN DMD (OWNER)
(215) 410-2049
Entity
Organization
Contact information
Practice address
1244 FORT WASHINGTON AVE, SUITE A, FORT WASHINGTON, PA 19034-1743
(215) 643-0363
Mailing address
1413 BEECH AVE, ELKINS PARK, PA 19027-3152
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
DS039121
PA
Other
Enumeration date
02/15/2016
Last updated
02/15/2016
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