| South Philadelphia Dental Group | |
|
1815 S Broad St Philadelphia PA 19148-2115 | |
| (215) 462-6229 | |
| (215) 467-9080 |
| Full Name | South Philadelphia Dental Group |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1815 S Broad St, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Gregory Chess (PARTNER) |
| Authorized Official Contact | 2154626229 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| South Philadelphia Dental Group 1815 S Broad St Philadelphia PA 19148-2115 Ph: (215) 462-6229 | South Philadelphia Dental Group 1815 S Broad St Philadelphia PA 19148-2115 Ph: (215) 462-6229 |
| NPI Number | 1255523650 |
|---|---|
| Provider Enumeration Date | 08/10/2007 |
| Last Update Date | 08/10/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255523650 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | DS-030824-L (Pennsylvania) | Primary |
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