Organization
9TH STREET DENTAL CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRENCE T FAN DMD (OWNER)
(215) 629-0596
Entity
Organization
Contact information
Practice address
821 S 9TH ST, PHILADELPHIA, PA 19147-2822
(215) 629-0599
(215) 629-0596
Mailing address
821 S 9TH ST, PHILADELPHIA, PA 19147-2822
(215) 629-0599
(215) 629-0596
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS-030933-L
PA
Other
Enumeration date
12/23/2015
Last updated
12/23/2015
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