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Organization
PENNSYLVANIA CENTER FOR DENTAL IMPLANTS AND PERIODONTICS, LLC
Active
Organization
PENNSYLVANIA CENTER FOR DENTAL IMPLANTS AND PERIODONTICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TAMI VISHIO (OFFICE MANAGER)
(215) 677-8686
Entity
Organization
Contact information
Practice address
9880 BUSTLETON AVE, SUITE 211-212, PHILADELPHIA, PA 19115-2185
(215) 677-8686
(215) 677-7212
Mailing address
9880 BUSTLETON AVE, SUITE 211-212, PHILADELPHIA, PA 19115-2185
(215) 677-8686
(215) 677-7212
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
DS022257L
PA
1223P0300X
Periodontics
DS039673
PA
Other
Enumeration date
02/12/2016
Last updated
02/12/2016
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