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Provider Information for 1316925373



PABLO E SOTELO D.M.D.

Gender: MALE

Individual NPI: 1316925373

Calendar Last Updated: 2008-06-11

Details

Name Value
NPI 1316925373
Enumeration Date 2006-01-09
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 9523 FRANKFORD AVE
PHILADELPHIA, PA 19114-2812
United States

Phone: 215-331-5757 | Fax: 215-331-6615
View Map External Link
Primary Practice Address 9523 FRANKFORD AVE
PHILADELPHIA, PA 19114-2812
United States

Phone: 215-331-5757 | Fax: 215-331-6615
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Other TAX IDENTIFICATION NUMBER PA 203029027
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 1223G0001X - Dentist General Practice PA DS-030460L