Individual
ASHIKA MANDARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1851 S COLUMBUS BLVD STE 1, PHILADELPHIA, PA 19148-2800
(215) 755-2559
Mailing address
350 N CLARK ST STE 600, C/O KOS SERVICES, CHICAGO, IL 60654-4782
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS040957
PA
Other
Enumeration date
05/16/2016
Last updated
08/22/2016
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