Individual
DR. PRIYA MAMACHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
6412 FRANKFORD AVE UNIT 10, PHILADELPHIA, PA 19135-3005
(215) 792-3055
Mailing address
1912 EMERSON ST, PHILADELPHIA, PA 19152-2306
(215) 454-9877
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS043584
PA
Other
Enumeration date
06/29/2022
Last updated
06/29/2022
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