| Temple University | |
|
3223 N Broad St Dept Of Periodontology Philadelphia PA 19140-5007 | |
| (215) 707-5774 | |
| Not Available |
| Full Name | Temple University |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 3223 N Broad St, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Keisuke Wada (DIRECTOR CHAIR OF PERIODONTOLOGY) |
| Authorized Official Contact | 2157077667 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Temple University 3223 N Broad St Philadelphia PA 19140-5007 Ph: (215) 707-5774 | Temple University 3223 N Broad St Dept Of Periodontology Philadelphia PA 19140-5007 Ph: (215) 707-5774 |
| NPI Number | 1720526130 |
|---|---|
| Provider Enumeration Date | 02/06/2017 |
| Last Update Date | 02/06/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720526130 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | 0401414955 (Virginia) | Primary |
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