Individual
EPIPHANY FITZPATRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1575 N 52ND ST STE 705, PHILADELPHIA, PA 19131-4729
(215) 879-1777
Mailing address
1575 N 52ND ST STE 705, PHILADELPHIA, PA 19131-4729
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS044283
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/24/2023
Last updated
08/16/2023
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