Organization
5TH STREET DENTAL CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHARON E WILSON (OWNER)
(215) 324-1950
Entity
Organization
Contact information
Practice address
4646 NORTH 5TH ST, PHILADELPHIA, PA 19140
(215) 324-1950
(215) 324-1950
Mailing address
4646 NORTH 5TH ST, PHILADELPHIA, PA 19140
(215) 324-1950
(215) 324-1950
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS018692-L
PA
Other
Enumeration date
02/15/2007
Last updated
04/08/2008
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