Organization
JWD INC
Active
Other names
Golden Block Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WINAH GALLAGHER D.M.D. (PRESIDENT)
(215) 739-2300
Entity
Organization
Contact information
Practice address
2757 N 5TH ST, PHILADELPHIA, PA 19133-2702
(215) 739-2300
(215) 739-2334
Mailing address
2757 N 5TH ST, PHILADELPHIA, PA 19133-2702
(215) 739-2300
(215) 739-2334
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS030007L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01656200
—
PA
Enumeration date
03/02/2006
Last updated
03/21/2008
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