Individual
DR. PHILIP A SHORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
200 TREATY RD, DREXEL HILL, PA 19026-5023
(610) 449-2424
Mailing address
200 TREATY RD, DREXEL HILL, PA 19026-5023
(610) 449-2424
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS019091L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
159499
UNITED CONCORDIA
PA
Enumeration date
12/11/2006
Last updated
07/08/2007
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