Organization
PROSPECT PARK COSMETIC DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHWETA GANDHI DMD (PRESIDENT)
(610) 532-5000
Entity
Organization
Contact information
Practice address
338 LINCOLN AVE, PROSPECT PARK, PA 19076-2421
(610) 532-4145
(610) 532-5000
Mailing address
338 LINCOLN AVE, PROSPECT PARK, PA 19076-2421
(610) 532-5000
(610) 461-1119
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
22DI02362100
NJ
261QD0000X
Dental Clinic/Center
Primary
DS037293
PA
Other
Enumeration date
03/03/2018
Last updated
03/03/2018
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