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Organization
UNIVERSITY OF PENNSYLVANIA
Active
Organization
UNIVERSITY OF PENNSYLVANIA
Active
Other names
Penn Dental Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALISA G KAUFFMAN DMD (CLINICAL DIRECTOR)
(215) 746-2944
Entity
Organization
Contact information
Practice address
240 S 40TH ST, PHILADELPHIA, PA 19104-6030
(215) 898-4615
Mailing address
240 S 40TH ST, PHILADELPHIA, PA 19104-6030
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS038838
PA
Other
Enumeration date
12/05/2014
Last updated
12/05/2014
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