MEDICARE: DR. ADRIANA WALSH PHILIP DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	DS041774	PA

General Provider Information

NPI Number	:	1396221123
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ADRIANA WALSH PHILIP DMD

Provider Business Mailing Address
First Line	:	1945 TIMBER LAKES DR
Second Line	:
City	:	YARDLEY
State	:	PA
Zip	:	19067-3919
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1226 LORD STERLING RD
Second Line	:
City	:	WASHINGTON CROSSING
State	:	PA
Zip	:	18977-1338
Country	:	US
Telephone Number	:	215-493-0784
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/15/2018
Last Update Date	:	07/15/2018

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