Organization
UNIVERSITY OF PENN CHOP DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH WOLK (DIRECTOR PATIENT REVENUE)
(215) 898-3576
Entity
Organization
Contact information
Practice address
34TH STREET AND CIVIC CENTER BOULEVARD, 2 MAIN, PHILADELPHIA, PA 19104
(215) 590-1563
Mailing address
34TH STREET AND CIVIC CENTER BOULEVARD, 2 MAIN, PHILADELPHIA, PA 19104
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DS020010L
PA
Other
Enumeration date
05/16/2007
Last updated
08/22/2020
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