Healthcare Provider Details

I. General information

NPI: 1528286945
Provider Name (Legal Business Name): ROOT CANAL ASSOC, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 S 16TH ST #900
PHILADELPHIA PA
19102
US

IV. Provider business mailing address

220 S 16TH ST #900
PHILADELPHIA PA
19102
US

V. Phone/Fax

Practice location:
  • Phone: 215-545-5455
  • Fax: 215-545-4107
Mailing address:
  • Phone: 215-545-5455
  • Fax: 215-545-4107

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number
License Number State

VIII. Authorized Official

Name: DR. LEONARD NORMAN PARRIS
Title or Position: OWNER
Credential: DMD
Phone: 215-595-5455