Individual
DR. PHILIP PAUL DAVERN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
231 CHESTNUT ST, SUITE 202, MEADVILLE, PA 16335-3442
(814) 724-4021
(814) 724-1193
Mailing address
231 CHESTNUT ST, SUITE 202, MEADVILLE, PA 16335-3442
(814) 724-4021
(814) 724-1193
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS021336L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0007528290001
—
PA
Enumeration date
10/25/2006
Last updated
07/08/2007
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