# SOUTH PHILADELPHIA DENTAL GROUP

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

## Provider details

- **NPI number:** 1255523650
- **Authorized official:** DR. GREGORY CHESS (PARTNER)
- **Authorized official phone:** (215) 462-6229

## Contact information

- **Practice address:** 1815 S BROAD ST, PHILADELPHIA, PA 19148-2115
- **Practice address phone:** (215) 462-6229
- **Practice address fax:** (215) 467-9080
- **Mailing address:** 1815 S BROAD ST, PHILADELPHIA, PA 19148-2115
- **Mailing address phone:** (215) 462-6229
- **Mailing address fax:** (215) 467-9080

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | DS-030824-L | PA | Yes |

## Other

- **Enumeration date:** 08/10/2007
- **Last updated:** 08/10/2007