Healthcare Provider Details

I. General information

NPI: 1144361767
Provider Name (Legal Business Name): JAMES TOROSIAN D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/08/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 LOCUST ST SUITE 1408
PHILADELPHIA PA
19102-4329
US

IV. Provider business mailing address

1500 LOCUST ST SUITE 1408
PHILADELPHIA PA
19102-4329
US

V. Phone/Fax

Practice location:
  • Phone: 215-732-4450
  • Fax: 215-735-9886
Mailing address:
  • Phone: 215-732-4450
  • Fax: 215-735-9886

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License NumberDS025616L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: