Individual
DR. MATTHEW WILFRED
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
8415 BUSTLETON AVE, PHILADELPHIA, PA 19152-1901
(215) 725-4564
Mailing address
931 CHARTER CIR, ELKINS PARK, PA 19027-1614
(267) 625-6846
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS043310
PA
1223G0001X
General Practice Dentistry
DS043310
PA
Other
Enumeration date
08/23/2021
Last updated
08/23/2021
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