Individual
DR. CHIZOBAM NKIRU IDAHOSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S., M.S.
Contact information
Practice address
1151 S BROAD ST, LANSDALE, PA 19446-5340
(215) 220-3395
(267) 449-0644
Mailing address
211 CHESTNUT LN, NORTH WALES, PA 19454-1303
(267) 984-2757
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
DS038657
PA
1223X2210X
Orofacial Pain Dentistry
DS038657
PA
125Q00000X
Oral Medicine Dentistry
Primary
DS038657
PA
Other
Enumeration date
09/29/2010
Last updated
06/03/2025
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