Individual
FADY BASILI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
5597 TULIP ST STE B4, PHILADELPHIA, PA 19124-1562
(732) 277-6427
Mailing address
29 PATRIOT WAY, HAINESPORT, NJ 08036-2635
(732) 277-6427
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS044234
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
10/05/2022
Last updated
07/10/2023
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