Healthcare Provider Details

I. General information

NPI: 1801261524
Provider Name (Legal Business Name): HAROLD SLUTSKY, D.M.D., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/07/2015
Last Update Date: 12/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7100 FRANKFORD AVE
PHILADELPHIA PA
19135-1009
US

IV. Provider business mailing address

7100 PRINCETON AVENUE
PHILADELPHIA PA
19135
US

V. Phone/Fax

Practice location:
  • Phone: 215-335-2500
  • Fax: 215-335-0875
Mailing address:
  • Phone: 215-335-2500
  • Fax: 215-335-0875

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. HAROLD SLUTSKY
Title or Position: PRESIDENT
Credential: D.M.D.
Phone: 215-335-2500