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Individual

DR. DEBRA VIVIAN IRVIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
5201 N BROAD ST, PHILA, PA 19141-1627
(215) 329-5512
(215) 329-0401
Mailing address
5201 N BROAD ST, PHILA, PA 19141-1627
(215) 329-5512
(215) 329-0401

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS023289L
PA

Other

Enumeration date
01/22/2006
Last updated
07/08/2007
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