Organization
LOCUST STREET PERIODONTICS IMPLANT DENTISTRY L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH GIAN-GRASSO D.M.D. (OWNER)
(215) 732-4450
Entity
Organization
Contact information
Practice address
1500 LOCUST ST., SUITE 1408, PHILADELPHIA, PA 19102-4314
(215) 732-4450
(215) 735-9886
Mailing address
1500 LOCUST ST., SUITE 1408, PHILADELPHIA, PA 19102-4314
(215) 732-4450
(215) 735-9886
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
DS018466L
PA
Other
Enumeration date
03/16/2007
Last updated
08/22/2020
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