Organization
PREMIER DENTISTRY OF PHILADELPHIA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHAHRAM SHAMLOO DMD (OWNER/DENTIST)
(215) 564-1025
Entity
Organization
Contact information
Practice address
1601 WALNUT ST, SUITE 1025, PHILADELPHIA, PA 19102-2944
(215) 564-1025
(215) 564-1027
Mailing address
1601 WALNUT ST, SUITE 1025, PHILADELPHIA, PA 19102-2944
(215) 564-1025
(215) 564-1027
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
05/01/2013
Last updated
05/01/2013
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