Provider Demographics
NPI:1356099030
Name:MINOLI, DAVID KAPLAN (DDS)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:KAPLAN
Last Name:MINOLI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4300 SPRUCE ST APT A202
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-4794
Mailing Address - Country:US
Mailing Address - Phone:857-202-8599
Mailing Address - Fax:
Practice Address - Street 1:2137 WELSH RD STE 3C
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19115-4963
Practice Address - Country:US
Practice Address - Phone:215-464-5600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-12
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS043507122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist