Provider Demographics
NPI:1992361794
Name:SUN DENTAL & ORTHODONTICS PA. INC.
Entity Type:Organization
Organization Name:SUN DENTAL & ORTHODONTICS PA. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JUNE
Authorized Official - Middle Name:
Authorized Official - Last Name:SUN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:215-334-2268
Mailing Address - Street 1:1164 S 11TH ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19147-4626
Mailing Address - Country:US
Mailing Address - Phone:215-334-2268
Mailing Address - Fax:
Practice Address - Street 1:1164 S 11TH ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19147-4626
Practice Address - Country:US
Practice Address - Phone:215-334-2268
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-16
Last Update Date:2019-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty