Organization
RONALD SICILIA ORAL SURGERY ASSOC LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RONALD F SICILIA DMD (PRESIDENT)
(215) 535-2255
Entity
Organization
Contact information
Practice address
5170 OXFORD AVE, PHILA, PA 19124-2532
(215) 535-2255
(215) 288-9376
Mailing address
5170 OXFORD AVE, PHILA, PA 19124-2532
(215) 535-2255
(215) 288-9376
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DS018365L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0060875000
KEYSTONE
—
01
—
4734
AETNA
—
Enumeration date
08/08/2006
Last updated
06/04/2012
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