Individual
DR. MICHAEL JOSEPH GAUGHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
255 S 17TH ST, SUITE 1309, PHILADELPHIA, PA 19103-6231
(215) 735-2915
(215) 735-5105
Mailing address
255 S 17TH ST, SUITE 1309, PHILADELPHIA, PA 19103-6231
(215) 735-2915
(215) 735-5105
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS024685L
PA
Other
Enumeration date
12/16/2006
Last updated
07/08/2007
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