# OLD CITY ORTHODONTICS LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Independence Orthodontics
- **Organization subpart:** No

## Provider details

- **NPI number:** 1811468929
- **Authorized official:** TYLER PARISI (BUSINESS MANAGER)
- **Authorized official phone:** (267) 225-3056

## Contact information

- **Practice address:** 14 S 3RD STREET, 1ST FLOOR, PHILADELPHIA, PA 19106
- **Practice address phone:** (267) 225-3056
- **Mailing address:** 14 S 3RD STREET, 1ST FLOOR, PHILADELPHIA, PA 19106
- **Mailing address phone:** (267) 225-3056

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 12/16/2018
- **Last updated:** 12/16/2018