Individual
ANGIE LEGUIZAMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
5501 OLD YORK RD STE 1, PHILADELPHIA, PA 19141-3098
(215) 456-7890
Mailing address
5501 OLD YORK RD STE 1, PHILADELPHIA, PA 19141-3098
(215) 456-7890
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS044887
PA
Other
Enumeration date
06/19/2023
Last updated
02/09/2025
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