Organization
DPMKENTNERPRPA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRYAN KENTNER DPM (OWNER)
(215) 696-3674
Entity
Organization
Contact information
Practice address
1923 WELSH RD, PHILADELPHIA, PA 19115-4659
(215) 677-3222
(215) 677-3241
Mailing address
11773 DIMARCO DR, PHILADELPHIA, PA 19154-3716
(215) 696-3674
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
SC004823L
PA
Other
Enumeration date
03/05/2007
Last updated
10/26/2007
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