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MAIN STREET DENTAL CENTER CITY PC NPI 1639370661


NPI Information

NPI: 1639370661
Provider Name: MAIN STREET DENTAL CENTER CITY PC
Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
1048 SOUTH ST
PHILADELPHIA, PA
ZIP 19147
Phone: (215) 627-1995
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MAIN STREET DENTAL CENTER CITY PC is a general practice dentist in Philadelphia, PA. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. MAIN STREET DENTAL CENTER CITY PC NPI is 1639370661. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1048 SOUTH ST
PHILADELPHIA, PA
ZIP 19147-935
Phone: (215) 627-1995
Fax: (215) 627-1999

The provider's authorized official is Richard Victor Eidelson .
The authorized official title is President Dentist and has the following contact phone number (215) 627-1995.

The enumeration date for this NPI number is 5/29/2007 and was last updated on 4/22/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223G0001XDentistGeneral PracticeDS019673LPENNSYLVANIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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