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Organization
UNIVERSITY OF PENN-DENTAL MED ASST
Active
Organization
UNIVERSITY OF PENN-DENTAL MED ASST
Active
Other names
Penn Personalized Care
Organization subpart
No
Provider details
NPI number
Authorized official
GARY W CROOKS (MD)
(215) 662-2450
Entity
Organization
Contact information
Practice address
3400 CIVIC CENTER BLVD, 1 EAST PAVILION, PHILADELPHIA, PA 19104-5127
(215) 662-2450
Mailing address
3400 CIVIC CENTER BLVD, 1 EAST PAVILION, PHILADELPHIA, PA 19104-5127
(215) 662-2450
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD028425E
PA
Other
Enumeration date
12/19/2011
Last updated
01/05/2012
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