| Oral Surgery Consultants Of Pennsylvania Pc | |
|
2546 S Broad St Philadelphia PA 19145-4638 | |
| (215) 463-4141 | |
| (215) 463-7616 |
| Full Name | Oral Surgery Consultants Of Pennsylvania Pc |
|---|---|
| Speciality | Dentist |
| Location | 2546 S Broad St, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Melissa P Rementer (INSURANCE COORDINATOR) |
| Authorized Official Contact | 2154633916 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Oral Surgery Consultants Of Pennsylvania Pc 2546 S Broad St Philadelphia PA 19145-4638 Ph: (215) 463-4141 | Oral Surgery Consultants Of Pennsylvania Pc 2546 S Broad St Philadelphia PA 19145-4638 Ph: (215) 463-4141 |
| NPI Number | 1134250517 |
|---|---|
| Provider Enumeration Date | 03/08/2007 |
| Last Update Date | 09/23/2022 |
| Medicare PECOS PAC ID | 6901960566 |
|---|---|
| Medicare Enrollment ID | O20090126000569 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134250517 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | DS030599L (Pennsylvania) | Primary |
| Provider Name | Brad Richman |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1780715029 PECOS PAC ID: 3870663008 Enrollment ID: I20080530000584 |
| Provider Name | Naveen Mohan |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1427319706 PECOS PAC ID: 3678988417 Enrollment ID: I20210209001093 |
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