South Park Family Dental Care Pa in - Dental
South Park Family Dental Care Pa - NPI 1467586768
South Park Family Dental Care Pa is a Dental in , . South Park Family Dental Care Pa practices all healthcare services and medical treatments related to Dental. The NPI Number for South Park Family Dental Care Pa is 1467586768. The last update date is 2011-05-24.
South Park Family Dental Care Pa's current location address is , , . You can contact this provider via phone number . The mailing address for South Park Family Dental Care Pa is , , . To know further, please read the information below!
Provider Profile Detail
| Provider Organization | South Park Family Dental Care Pa |
|---|---|
| Address | , , |
| Phone Number | |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PRESIDENT |
|---|---|
| Authorized Official Name | Izaddoust Shiva |
| Credentials | D.D.S. |
| Telephone Number | 2109271400 |
NPI Number Detail
| NPI Number | 1467586768 |
|---|---|
| Provider Enumeration Date | 2007-03-16 |
| Last Updated Date | 2011-05-24 |
Provider Mailing Address Detail
| Address | |
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| City | |
| State | () |
| Post Code | |
| Phone Number | |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Dental |
|---|---|
| Taxonomy | 261Qd0000X |
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Definition: Provides general and specialized dental care and oral surgery. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| G60126-3 | TX | TEXAS CHIP | |
| 0064GJ | TX | BLUE CROSS BLUE SHIELD | |
| 1300537 | TX | UNITED CONCORDIA | |
| 0099152-01 | TX | -- |
Post Comment/ Review Below
What is the South Park Family Dental Care Pa's 1467586768?
The South Park Family Dental Care Pa's NPI (National Provider Identifier) Number is 1467586768. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete street address where South Park Family Dental Care Pa is physically located?
The South Park Family Dental Care Pa is physically situated at the following address: , , , .
What is the area of specialization for South Park Family Dental Care Pa, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for South Park Family Dental Care Pa is Dental, and the corresponding taxonomy code that categorizes this area of expertise is 261Qd0000X.
On what date did South Park Family Dental Care Pa receive its 1467586768 assignment from the Centers for Medicare & Medicaid Services?
The South Park Family Dental Care Pa was assigned its 1467586768 on 2007-03-16, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
When was the South Park Family Dental Care Pa's information last updated?
The South Park Family Dental Care Pa's information was last updated on 2011-05-24.