Organization · NPI-2

Center City Oral & Maxillofacial Surgery

Dentist, Oral and Maxillofacial Surgery · Philadelphia, PA

NPI number1376990853
StatusActive
Last updated in NPPESMay 16, 2016

Details

NPI
1376990853
Entity type
Organization (NPI-2)
Legal business name
Center City Oral & Maxillofacial Surgery
Organization subpart
No
Enumeration date
May 16, 2016
Last updated
May 16, 2016

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1223S0112X Dentist, Oral and Maxillofacial SurgeryDS035784PAYes
204E00000X Oral & Maxillofacial SurgeryDS035784PA

Practice location

1740 South St Ste 302
Philadelphia, PA 19146-1572

Phone 267-437-7540 · Fax 267-437-7541

Mailing address

2422 Naudain St
Philadelphia, PA 19146-1030

Phone 215-290-9778

Authorized official

Kai-Zu Chi
Dr
2152909778

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