Healthcare Provider Details

I. General information

NPI: 1841685732
Provider Name (Legal Business Name): PHILADELPHIA HEADACHE RELIEF CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2015
Last Update Date: 03/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 GEIGER RD SUITE A
PHILADELPHIA PA
19115-1009
US

IV. Provider business mailing address

211 GEIGER RD SUITE A
PHILADELPHIA PA
19115-1009
US

V. Phone/Fax

Practice location:
  • Phone: 215-676-3070
  • Fax: 215-676-4530
Mailing address:
  • Phone: 215-676-3070
  • Fax: 215-676-4530

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License NumberDS039634
License Number StatePA

VIII. Authorized Official

Name: DR. ANDREW M APPEL
Title or Position: OWNER
Credential: DMD
Phone: 215-676-3070