Healthcare Provider Details

I. General information

NPI: 1558561100
Provider Name (Legal Business Name): LORRON TAMIKA TOKPA D.M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2007
Last Update Date: 06/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 PENN BLVD SUITE 216
PHILADELPHIA PA
19144-1416
US

IV. Provider business mailing address

2 PENN BLVD SUITE 216
PHILADELPHIA PA
19144-1416
US

V. Phone/Fax

Practice location:
  • Phone: 215-951-8900
  • Fax:
Mailing address:
  • Phone: 215-951-8900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDS037487
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: