Organization
PERIODONTAL CONSULTANTS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MELISSA REMENTER (INSURANCE COORDINATOR)
(215) 940-9001
Entity
Organization
Contact information
Practice address
2546 S BROAD ST REAR, PHILADELPHIA, PA 19145-4638
(215) 463-6677
Mailing address
2546 S BROAD ST REAR, PHILADELPHIA, PA 19145-4638
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
—
—
Other
Enumeration date
09/20/2013
Last updated
09/20/2013
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