Provider Demographics
NPI:1679750145
Name:MAYFAIR DENTAL ASSOCIATES LTD.
Entity type:Organization
Organization Name:MAYFAIR DENTAL ASSOCIATES LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:J
Authorized Official - Last Name:KAYE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:215-335-1889
Mailing Address - Street 1:3541 RYAN AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19136-4313
Mailing Address - Country:US
Mailing Address - Phone:215-335-1889
Mailing Address - Fax:215-335-1889
Practice Address - Street 1:3541 RYAN AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19136-4313
Practice Address - Country:US
Practice Address - Phone:215-335-1889
Practice Address - Fax:215-335-1889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-28
Last Update Date:2008-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS025188L261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental