Individual
ALYSSA SOUTHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
1250 GREENWOOD AVE STE 10, JENKINTOWN, PA 19046-2900
(215) 887-4004
Mailing address
1283 LINCOLN HIGHWAY, LEVITTOWN, PA 19056
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS042469
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/27/2019
Last updated
02/25/2026
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