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Organization
TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA
Active
Organization
TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH JOHNSTON (EXECUTIVE DIRECTOR)
(215) 662-7583
Entity
Organization
Contact information
Practice address
240 S 40TH ST, PHILADELPHIA, PA 19104-6030
(215) 898-5344
(215) 898-3139
Mailing address
3624 MARKET ST, SUITE 560W, PHILADELPHIA, PA 19104-2614
(215) 662-2286
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
—
PA
Other
Enumeration date
03/28/2007
Last updated
08/22/2020
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