Individual
TYLER SORENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5139 CHESTNUT ST, PHILADELPHIA, PA 19139-3430
(215) 471-1600
Mailing address
5139 CHESTNUT ST, PHILADELPHIA, PA 19139-3430
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
038192
PA
Other
Enumeration date
04/29/2010
Last updated
04/29/2010
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