# 9TH STREET DENTAL CENTER PC

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

## Provider details

- **NPI number:** 1134584899
- **Authorized official:** TERRENCE T FAN DMD (OWNER)
- **Authorized official phone:** (215) 629-0596

## Contact information

- **Practice address:** 821 S 9TH ST, PHILADELPHIA, PA 19147-2822
- **Practice address phone:** (215) 629-0599
- **Practice address fax:** (215) 629-0596
- **Mailing address:** 821 S 9TH ST, PHILADELPHIA, PA 19147-2822
- **Mailing address phone:** (215) 629-0599
- **Mailing address fax:** (215) 629-0596

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | DS-030933-L | PA | Yes |

## Other

- **Enumeration date:** 12/23/2015
- **Last updated:** 12/23/2015