Organization
PENNSYLVANIA CENTER FOR DENTAL IMPLANTS AND PERIODONTICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TAMI VISHIO (OFFICE MANAGER)
(215) 677-8686
Entity
Organization
Contact information
Practice address
9880 BUSTLETON AVE, SUITE 211-212, PHILADELPHIA, PA 19115-2185
(215) 677-8686
(215) 677-7212
Mailing address
9880 BUSTLETON AVE, SUITE 211-212, PHILADELPHIA, PA 19115-2185
(215) 677-8686
(215) 677-7212
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
DS022257L
PA
1223P0300X
Periodontics
DS039673
PA
Other
Enumeration date
02/12/2016
Last updated
02/12/2016
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