Organization
JEFFERSON UNIVERSITY PHYSICIANS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAWN PADGETT (CREDENTIALING MANAGER)
(215) 955-1175
Entity
Organization
Contact information
Practice address
833 CHESTNUT ST, SUITE 630, PHILADELPHIA, PA 19107-4414
(215) 955-0800
Mailing address
PO BOX 828937, PHILADELPHIA, PA 19182-8937
(215) 503-1240
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
PA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
—
—
Other
Enumeration date
04/25/2016
Last updated
06/13/2024
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