Provider Demographics
NPI:1477683829
Name:KAMINSKY DENTAL ASSOCIATES P C
Entity Type:Organization
Organization Name:KAMINSKY DENTAL ASSOCIATES P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RANDE
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:KAMINSKY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:215-972-9722
Mailing Address - Street 1:1500 MARKET ST
Mailing Address - Street 2:CENTRE SQUARE BUILDING, LOWER MEZZANINE, WEST TOWER
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19102-2100
Mailing Address - Country:US
Mailing Address - Phone:215-972-9722
Mailing Address - Fax:215-972-0716
Practice Address - Street 1:1500 MARKET ST
Practice Address - Street 2:CENTRE SQUARE BUILDING, LOWER MEZZANINE, WEST TOWER
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19102-2100
Practice Address - Country:US
Practice Address - Phone:215-972-9722
Practice Address - Fax:215-972-0716
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS024820L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty