| Type | Company | [sources] | |||
|---|---|---|---|---|---|
| Name | Easy Dental PC | [sources] | |||
| Incorporation date | not available | [sources] | |||
| Jurisdiction | not available | [sources] | |||
| Country | United States | [sources] | |||
| NPI | 1093093585 | [sources] | |||
| Registration number | not available | [sources] | |||
| Tax Number | 452501911 | [sources] | |||
| Address | 5616 GERMANTOWN AVENUE, PHILADELPHIA, PA 19114 · Philadelphia, PA | [sources] | |||
| Last change | Last processed | First seen | |||
Medical providers disqualified from participating in New Jersey State's Medicaid program.
United States · OIFP
Medical providers who are precluded from participation in the Medical Assistance Program
United States · DHS
us-mednj-18f0b5f0417124c09125d694fb6b211748676612 · us-medpa-e606f161df8f4f1b2f1475d78626dece442be105For experts: raw data explorer
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| Address | ||
|---|---|---|
| Full address | Country | |
| 5616 GERMANTOWN AVENUE, PHILADELPHIA, PA 19114 | United States | |
| United States | New Jersey Office of the State Comptroller | - | - |
| Philadelphia, PA | United States |