Healthcare Provider Details

I. General information

NPI: 1023228889
Provider Name (Legal Business Name): MEHMET ILHAN UZEL D.M.D.,D.SC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

722 MARKET ST
PHILADELPHIA PA
19106-2312
US

IV. Provider business mailing address

102 SCHOOL HOUSE LN
ARDMORE PA
19003-3310
US

V. Phone/Fax

Practice location:
  • Phone: 215-922-5100
  • Fax:
Mailing address:
  • Phone: 617-827-4038
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDS037006
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number21477
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number22DI02344800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: