# PATRICE IERARDI DMD LLC

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

## Provider details

- **NPI number:** 1679895874
- **Authorized official:** DR. PATRICE IERARDI DMD (DENTIST/OWNER)
- **Authorized official phone:** (215) 238-0849

## Contact information

- **Practice address:** 21 S 5TH ST, SUITE 610, PHILADELPHIA, PA 19106-2515
- **Practice address phone:** (215) 238-0849
- **Practice address fax:** (215) 413-0377
- **Mailing address:** 21 S 5TH ST, SUITE 610, PHILADELPHIA, PA 19106-2515
- **Mailing address phone:** (215) 238-0849
- **Mailing address fax:** (215) 413-0377

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | DS024194L | PA | Yes |

## Other

- **Enumeration date:** 02/16/2010
- **Last updated:** 02/16/2010