Individual
MISS SAMANTHA TING GUAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6595C ROOSEVELT BLVD, PHILADELPHIA, PA 19149-2918
(215) 743-3700
(215) 743-3715
Mailing address
400 BEALE ST, QUINCY, MA 02170-3228
(857) 756-0349
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
7714
NE
1223P0221X
Pediatric Dentistry
22DI03027500
NJ
1223P0221X
Pediatric Dentistry
Primary
DS043509
PA
Other
Enumeration date
04/29/2021
Last updated
07/09/2024
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