Individual
DR. JUSTIN MIDDLEBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2137 WELSH RD STE 1B, PHILADELPHIA, PA 19115-4963
(215) 676-7846
Mailing address
5501 OLD YORK RD STE 1, PHILADELPHIA, PA 19141-3098
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DS042955
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/15/2020
Last updated
06/14/2023
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