Healthcare Provider Details

I. General information

NPI: 1912036203
Provider Name (Legal Business Name): ORHAN CECIL TUNCAY DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/05/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1518 WALNUT ST SUITE 500
PHILADELPHIA PA
19102-3419
US

IV. Provider business mailing address

1518 WALNUT ST SUITE 500
PHILADELPHIA PA
19102-3419
US

V. Phone/Fax

Practice location:
  • Phone: 215-772-0775
  • Fax: 215-772-0732
Mailing address:
  • Phone: 215-772-0775
  • Fax: 215-772-0732

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License NumberDS029412R
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: