Samuel P Hutagalung Tam DMD

NPI 1104150168 - Dentist - 122300000X

NPI Details
NPI 1104150168
Gender Male
Enumeration Date 09/23/2009
Last Updated 09/23/2009
Entity Type Individual
Active Over 7 years ago
Practice Location
2020 WALNUT ST APT 6C
PHILADELPHIA PA, 19103-5600, US
Phone (267) 467-0092
Fax
Business Location
2020 WALNUT ST APT 6C
PHILADELPHIA PA, 19103-5600, US
Phone (267) 467-0092
Fax
Toxanomy
Taxonomy Code 122300000X
License State Pennsylvania
License Number DS038083
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According to our database, Dr. Samuel P Hutagalung Tam DMD NPI is 1104150168, taxonomy code is 122300000X and license number is DS038083, license state is located at Pennsylvania. Samuel P Hutagalung Tam DMD physically located at 2020 Walnut St Apt 6c, Philadelphia PA, 19103-5600. NPI Number Samuel P Hutagalung Tam DMD has the Individual type.

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1104150168 NPI number is provided on an as is basis without warranty of any kind. 1104150168 is maintained by the National Plan & Provider Enumeration System. The contents of Samuel P Hutagalung Tam DMD are for informational purposes only.