Individual
WAEL FARES ISLEEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1575 N 52ND ST STE 705, PHILADELPHIA, PA 19131-4729
(215) 879-1777
Mailing address
1575 N 52ND ST STE 705, PHILADELPHIA, PA 19131-4729
(215) 879-1777
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS041828
PA
Other
Enumeration date
08/13/2018
Last updated
08/13/2018
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