Provider Demographics
NPI:1285270835
Name:PERFECT SMILE DENTAL OF NEW KENSINGTON PC
Entity type:Organization
Organization Name:PERFECT SMILE DENTAL OF NEW KENSINGTON PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PENG
Authorized Official - Middle Name:
Authorized Official - Last Name:CHENG
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:814-942-4699
Mailing Address - Street 1:125 E PLEASANT VALLEY BLVD
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16602-5544
Mailing Address - Country:US
Mailing Address - Phone:814-942-4699
Mailing Address - Fax:814-942-4587
Practice Address - Street 1:825 5TH AVE
Practice Address - Street 2:
Practice Address - City:NEW KENSINGTON
Practice Address - State:PA
Practice Address - Zip Code:15068-6303
Practice Address - Country:US
Practice Address - Phone:724-337-9360
Practice Address - Fax:724-337-9363
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-19
Last Update Date:2019-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty