Individual
SHACHIKA KHANNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
909 WALNUT STREET, 300 COB, PHILADELPHIA, PA 19107-5211
(215) 955-6215
(215) 923-9189
Mailing address
909 WALNUT STREET, 300 COB, PHILADELPHIA, PA 19107-5211
(215) 955-6215
(215) 923-9189
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DS039059
PA
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
DS039059
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/03/2008
Last updated
08/23/2019
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