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Individual

DR. ALLEN FRED FIELDING

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
101 E LEHIGH AVE, PM2, PHILADELPHIA, PA 19125-1011
(215) 707-3613
(215) 707-5405
Mailing address
101 E LEHIGH AVE, PM2, PHILADELPHIA, PA 19125-1011
(215) 707-3613
(215) 707-5405

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DS016909L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0060874000
KEYSTONE EAST
PA
01
01684301
CAPITAL BLUE CROSS
PA
01
0582812
AETNA HEALTHCARE
PA
01
2000631
KEYSTONE CENTRAL
PA
Enumeration date
09/26/2006
Last updated
12/10/2012
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