Organization
DEBRA V. IRVIN, DDS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEBRA VIVIAN IRVIN DDS (OWNER DENTIST)
(215) 329-5512
Entity
Organization
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
261QD0000X
Dental Clinic/Center
Primary
DS023289L
PA
Other
Enumeration date
11/08/2010
Last updated
11/08/2010
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