Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Pennsylvania Dental Group Ltd

Organization General Practice Dentistry · NPI 1114054962

Pennsylvania Dental Group Ltd provides General Practice Dentistry in Philadelphia, Pennsylvania. Licensed in Pennsylvania. Registered with an NPI since 2007.

Licensed in
PA
In the registry since
2007
What do these letters mean?
Ltd — Limited
A form of business registration, not a clinical qualification.

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Practice location Address checks out

3550 Market St
Philadelphia, PA 19104-3329
Phone: (215) 387-0883
Fax: (215) 387-9659
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence DS18682L (PA)

Record details

NPI number1114054962
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official George Boudreau — President · (215) 387-0883
NPI enumeratedFebruary 28, 2007
Last updated in NPPESAugust 22, 2020
Mailing address3550 Market St, Philadelphia, PA 19104-3329

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