Organization
OLD CITY ORTHODONTICS LLC
Active
Other names
Independence Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
TYLER PARISI (BUSINESS MANAGER)
(267) 225-3056
Entity
Organization
Contact information
Practice address
14 S 3RD STREET, 1ST FLOOR, PHILADELPHIA, PA 19106
(267) 225-3056
Mailing address
14 S 3RD STREET, 1ST FLOOR, PHILADELPHIA, PA 19106
(267) 225-3056
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
12/16/2018
Last updated
12/16/2018
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