Provider Demographics
NPI:1083958847
Name:UNTERMAN, PEARL ADINA (DMD)
Entity Type:Individual
Prefix:DR
First Name:PEARL
Middle Name:ADINA
Last Name:UNTERMAN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 SNYDER AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19148-2710
Mailing Address - Country:US
Mailing Address - Phone:215-383-1376
Mailing Address - Fax:
Practice Address - Street 1:48 SNYDER AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19148-2710
Practice Address - Country:US
Practice Address - Phone:215-383-1376
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-18
Last Update Date:2015-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI025140001223G0001X
NJ22DI025140011223G0001X
PADS039148122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice