Individual
DR. REBECCA GOLLUB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
240 S 40TH ST, PHILADELPHIA, PA 19104-6030
(215) 898-6555
Mailing address
240 S 40TH ST, PHILADELPHIA, PA 19104-6030
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS042694
PA
1223P0221X
Pediatric Dentistry
DS042694
PA
Other
Enumeration date
06/26/2020
Last updated
10/04/2020
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