Individual
CHARLES TOLLIFERREO JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
61 W CHELTEN AVE, PHILADELPHIA, PA 19144-2701
(215) 713-2626
Mailing address
506B GLEN ECHO RD, PHILADELPHIA, PA 19119-2916
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS042886
PA
Other
Enumeration date
08/04/2020
Last updated
08/14/2020
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