Organization
INFANT LASER DENTISTRY PC
Active
Organization
INFANT LASER DENTISTRY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK GOLDSTEIN DDS (PRESIDENT)
(215) 743-3700
Entity
Organization
Contact information
Practice address
2301 E ALLEGHENY AVE, SUITE 201, PHILADELPHIA, PA 19134-4427
(215) 282-9901
Mailing address
6404 ROOSEVELT BLVD, PHILADELPHIA, PA 19149-2943
(215) 743-3700
(215) 743-3706
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
06/06/2016
Last updated
06/14/2016
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