Organization
DENTISTRY AT 1818 MARKET ST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELAINE COADY (OFFICE MANAGER)
(215) 567-2666
Entity
Organization
Contact information
Practice address
1818 MARKET ST, SUITE 100, PHILADELPHIA, PA 19103-3638
(215) 567-2666
Mailing address
1818 MARKET ST, SUITE 100, PHILADELPHIA, PA 19103-3638
(215) 567-2666
Taxonomy
Speciality
Code
Description
License number
State
125K00000X
Advanced Practice Dental Therapist
Primary
DS017950
PA
Other
Enumeration date
07/26/2016
Last updated
07/26/2016
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