Organization
DENTAL ARTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARYAM ROSTAMI DMD (PARTNER DENTIST)
(215) 575-0550
Entity
Organization
Contact information
Practice address
1601 WALNUT ST, SUITE 1217, PHILADELPHIA, PA 19102-2944
(215) 575-0550
Mailing address
2300 WALNUT ST, SUITE 1217, PHILADELPHIA, PA 19103-5552
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS039480
PA
122300000X
Dentist
DS039657
PA
124Q00000X
Dental Hygienist
DH071243
PA
Other
Enumeration date
02/13/2015
Last updated
02/13/2015
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