Individual
MRS. LISA ANN RAVETZ
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
199 W CHAMPLOST ST, PHILADELPHIA, PA 19120-1904
(215) 924-7891
Mailing address
199 W CHAMPLOST ST, PHILADELPHIA, PA 19120-1904
(215) 924-7891
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS024326L
PA
Other
Enumeration date
11/02/2005
Last updated
07/08/2007
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