MEDICARE: DR. PHILIP S. SPRINGER D.M.D.

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	DS-019745L	PA

General Provider Information

NPI Number	:	1639174428
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PHILIP S. SPRINGER D.M.D.

Provider Business Mailing Address
First Line	:	2400 CHESTNUT ST
Second Line	:	LBBY LEVEL
City	:	PHILADELPHIA
State	:	PA
Zip	:	19103-4316
Country	:	US
Telephone Number	:	215-977-8144
Fax Number	:	215-977-8675

Provider Business Practice Location Address
First Line	:	2400 CHESTNUT ST
Second Line	:	LBBY LEVEL
City	:	PHILADELPHIA
State	:	PA
Zip	:	19103-4316
Country	:	US
Telephone Number	:	215-977-8144
Fax Number	:	215-977-8675

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

Provider Enumeration Date	:	06/17/2005
Last Update Date	:	07/08/2007

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