Individual
DR. MARY JO KASENCHAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
2144 CECIL B MOORE AVE, PHILADELPHIA, PA 19121-4014
(215) 320-6187
Mailing address
2144 CECIL B MOORE AVE, PHILADELPHIA, PA 19121-4014
(215) 320-6187
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS040790
PA
Other
Enumeration date
05/26/2016
Last updated
12/15/2016
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