South Philadelphia Oral And Maxillofacial Surgery Associates Pc | |
1613 South Broad St Philidelphia PA 19148 | |
(215) 389-2511 | |
(215) 389-0334 |
Full Name | South Philadelphia Oral And Maxillofacial Surgery Associates Pc |
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Speciality | Dentist - Oral And Maxillofacial Surgery |
Location | 1613 South Broad St, Philidelphia, Pennsylvania |
Authorized Official Name and Position | Robert Michael Wohar (PRESIDENT) |
Authorized Official Contact | 2153892511 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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South Philadelphia Oral And Maxillofacial Surgery Associates Pc 1613 South Broad St Philidelphia PA 19148 Ph: (215) 389-2511 | South Philadelphia Oral And Maxillofacial Surgery Associates Pc 1613 South Broad St Philidelphia PA 19148 Ph: (215) 389-2511 |
NPI Number | 1952411720 |
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Provider Enumeration Date | 08/30/2006 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1952411720 | NPI | - | NPPES |
0317930000 | Other | PA | KEYSTONE HEALTH PLAN EAST |
117949 | Other | PA | INDEPENCE BLUE CROSS PERS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |