Provider Demographics
NPI:1790485134
Name:GOOD VIBES DENTISTRY LLC
Entity Type:Organization
Organization Name:GOOD VIBES DENTISTRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:H
Authorized Official - Last Name:URAM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:215-901-2655
Mailing Address - Street 1:737 BAINBRIDGE ST # 7300
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19147-2058
Mailing Address - Country:US
Mailing Address - Phone:215-901-2655
Mailing Address - Fax:
Practice Address - Street 1:232 DOVE RUN CENTRE DR
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:DE
Practice Address - Zip Code:19709-7971
Practice Address - Country:US
Practice Address - Phone:302-449-6810
Practice Address - Fax:302-449-6222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-06
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental