Individual
DR. DANIEL IAN TAUB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MD
Contact information
Practice address
909 WALNUT STREET, 300 COB, PHILADELPHIA, PA 19107-5211
(215) 955-6215
(215) 923-9189
Mailing address
909 WALNUT STREET, 300COB, PHILADELPHIA, PA 19107-5211
(215) 955-6215
(215) 923-9189
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DS030442L
PA
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
MD430367
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1011106450001
—
PA
Enumeration date
06/19/2006
Last updated
08/22/2019
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