Provider Demographics
NPI:1134944960
Name:DENTAL IMPLANT SPECIALISTS OF PENNSYLVANIA II, PC
Entity type:Organization
Organization Name:DENTAL IMPLANT SPECIALISTS OF PENNSYLVANIA II, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:RIAD
Authorized Official - Middle Name:
Authorized Official - Last Name:ALMASRI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-688-5555
Mailing Address - Street 1:3500 MAPLE AVE STE 1600
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75219-3936
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1601 WALNUT ST STE 1217
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19102-2908
Practice Address - Country:US
Practice Address - Phone:215-575-0550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-18
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty