MEDICARE: DR. VICKY CHANG ARTHUR D.D.S.

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	122300000X	Dentist	DS027078L	PA

General Provider Information

NPI Number	:	1801884994
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VICKY CHANG ARTHUR D.D.S.

Provider Business Mailing Address
First Line	:	1215 GULPH CREEK DR
Second Line	:
City	:	RADNOR
State	:	PA
Zip	:	19087-4687
Country	:	US
Telephone Number	:	215-477-8800
Fax Number	:	215-477-8800

Provider Business Practice Location Address
First Line	:	1025 N 66TH ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19151-3104
Country	:	US
Telephone Number	:	215-477-8800
Fax Number	:	215-477-8800

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

Provider Enumeration Date	:	10/12/2005
Last Update Date	:	07/08/2007

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