Individual
DR. RICHARD C SQUILLARO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2546 S BROAD ST, PHILADELPHIA, PA 19145-4638
(215) 463-6677
(215) 463-1077
Mailing address
2546 S BROAD ST, PHILADELPHIA, PA 19145-4638
(215) 463-6677
(215) 463-1077
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
DS017459L
PA
Other
Enumeration date
05/14/2013
Last updated
05/14/2013
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