Organization
NICHOLAS COSMETIC DENTAL CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHIREEN MALIK (DENTIST)
(917) 239-9313
Entity
Organization
Contact information
Practice address
1128 WALNUT STREET, 5TH FLOOR, PHILADELPHIA, PA 19107
(646) 241-6384
Mailing address
1128 WALNUT STREET, 5TH FLOOR, PHILADELPHIA, PA 19107
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS038604
PA
Other
Enumeration date
09/28/2011
Last updated
09/28/2011
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