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Individual

DR. STEPHANIE RAVETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.M.D.

Contact information

Practice address
6012 GREENE ST, PHILADELPHIA, PA 19144-2726
(215) 843-9400
Mailing address
6012 GREENE ST, PHILADELPHIA, PA 19144-2726
(215) 843-9400

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
024857
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1265597355
NPI TYPE 2
PA
Enumeration date
05/12/2010
Last updated
05/12/2010
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