Individual
DAVID GARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1714 LOCUST ST, SUITE 2, PHILADELPHIA, PA 19103-6153
(215) 732-2490
(215) 732-2490
Mailing address
1714 LOCUST ST, SUITE 2, PHILADELPHIA, PA 19103-6153
(215) 732-2490
(215) 732-2490
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS037861
PA
Other
Enumeration date
12/18/2009
Last updated
06/07/2012
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