Provider Demographics
NPI:1073050399
Name:DA VINCI DENTAL SPECIALISTS INC.
Entity Type:Organization
Organization Name:DA VINCI DENTAL SPECIALISTS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:ALOIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-677-2022
Mailing Address - Street 1:10108 BUSTLETON AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19116-3704
Mailing Address - Country:US
Mailing Address - Phone:215-677-2022
Mailing Address - Fax:267-343-5772
Practice Address - Street 1:10108 BUSTLETON AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19116-3704
Practice Address - Country:US
Practice Address - Phone:215-677-2022
Practice Address - Fax:267-343-5772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-24
Last Update Date:2017-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty