Individual
POOJA GANGWANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
3223 N BROAD ST, PHILADELPHIA, PA 19140-5007
(215) 707-7721
Mailing address
3223 N BROAD ST, PHILADELPHIA, PA 19140-5007
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
060025-1
NY
Other
Enumeration date
06/10/2013
Last updated
01/05/2023
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