Individual
REEM FADL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DS
Contact information
Practice address
4510 FRANKFORD AVE, PHILA, PA 19124-3602
(215) 535-1990
(215) 535-1935
Mailing address
432 N 6TH ST, PHILA, PA 19123-4004
(215) 925-2400
(215) 925-9162
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS031629L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101683193
—
PA
Enumeration date
01/22/2007
Last updated
02/13/2013
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