Provider Demographics
NPI:1790376747
Name:PURE DENTISTRY LLC
Entity Type:Organization
Organization Name:PURE DENTISTRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KUNAL
Authorized Official - Middle Name:
Authorized Official - Last Name:PARIKH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-664-3606
Mailing Address - Street 1:1601 WALNUT ST STE 1217
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19102-2908
Mailing Address - Country:US
Mailing Address - Phone:215-575-0550
Mailing Address - Fax:215-575-0554
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:215-575-0554
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-02
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental