# 2020DENTISTRY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063869030
- **Authorized official:** DR. PIERRE J MOURADIAN DMD (DENTIST)
- **Authorized official phone:** (215) 567-4949

## Contact information

- **Practice address:** 1601 WALNUT ST, SUITE 801, PHILA, PA 19102
- **Practice address phone:** (215) 567-4949
- **Practice address fax:** (215) 567-0901
- **Mailing address:** 1601 WALNUT ST, SUITE 801, PHILADELPHIA, PA 19102-2944
- **Mailing address phone:** (215) 567-4949
- **Mailing address fax:** (215) 567-0901

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 027190-L | PA | Yes |

## Other

- **Enumeration date:** 05/19/2016
- **Last updated:** 05/19/2016