Tianyuan Shi, DMD
Dentist, General Practice in Philadelphia, PA. Individual provider (NPI-1).
NPI number1669900692
StatusActive
Last updated in NPPESJun 4, 2017
Details
- NPI
- 1669900692
- Entity type
- Individual (NPI-1)
- Name
- Tianyuan Shi
- Credential
- DMD
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 4, 2017
- Last updated
- Jun 4, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | DS041317 | PA | Yes |
Practice location
2010 S Juniper StPhiladelphia, PA 19148-5509
Phone 215-334-3490
Mailing address
4101 Spruce St Apt 319Philadelphia, PA 19104-4083
Phone 518-488-7050
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