Individual
CAMPO ELIAS PEREZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
240 S 40TH ST, PHILADELPHIA, PA 19104-6030
(215) 898-8965
Mailing address
1500 LOCUST ST APT 2604, PHILADELPHIA, PA 19102-4339
(617) 320-1298
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
10395
MA
1223P0300X
Periodontics
Primary
RFD000029
PA
Other
Enumeration date
09/30/2008
Last updated
04/11/2019
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