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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
250 KING OF PRUSSIA RD, RADNOR, PA 19087-5220
(610) 902-5600
(610) 902-5604
Mailing address
3624 MARKET ST, SUITE 560W, PHILADELPHIA, PA 19104-2614
(215) 662-2286
(215) 615-0500
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
—
PA
Other
Enumeration date
08/21/2006
Last updated
01/06/2014
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