Individual
DR. LISA MYRUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
2459 ARAMINGO AVE, PHILADELPHIA, PA 19125-3731
(215) 427-2800
Mailing address
350 N CLARK ST FL 6, DENTAL DREAMS LLC C/O JULIETTE BOYCE, CHICAGO, IL 60654-4712
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DS039524
PA
1223P0221X
Pediatric Dentistry
Primary
DS039524
PA
Other
Enumeration date
05/15/2013
Last updated
07/08/2019
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