| Patelka Dental On Wheels | |
|
8332 Bustleton Ave Unit B Philadelphia PA 19152-1909 | |
| (215) 342-5090 | |
| Not Available |
| Full Name | Patelka Dental On Wheels |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 8332 Bustleton Ave, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Svetlana Kutovoy (OWNER) |
| Authorized Official Contact | 2153425090 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Patelka Dental On Wheels Po Box 51027 Philadelphia PA 19115-0027 Ph: (215) 342-5090 | Patelka Dental On Wheels 8332 Bustleton Ave Unit B Philadelphia PA 19152-1909 Ph: (215) 342-5090 |
| NPI Number | 1386992873 |
|---|---|
| Provider Enumeration Date | 08/15/2012 |
| Last Update Date | 08/15/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386992873 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | DS020408L (Pennsylvania) | Primary |
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