Individual
DR. RICHARD VICTOR EIDELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS, FAGD
Contact information
Practice address
1048 SOUTH ST, PHILADELPHIA, PA 19147-1935
(215) 627-1995
(215) 627-1999
Mailing address
1048 SOUTH ST, PHILADELPHIA, PA 19147-1935
(215) 627-1995
(215) 627-1999
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS019673L
PA
Other
Enumeration date
05/14/2007
Last updated
05/17/2011
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