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General NPI Number Information
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NPI Number | 1306316104
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Entity Type | Individual
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Provider Name | CARMEN DOUMIT BDS, MS, CAGS
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Gender | Female
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Dates
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Enumeration Date | 12/05/2018
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Last Update Date | 02/03/2022
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Provider Practice Location Address
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Address Line | 3223 N BROAD STREET TEMPLE UNIVERSITY DEPARTMENT OF ORTHODONTICS
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City | PHILADELPHIA
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State | PA
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Zip | 19140
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Country | US
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Telephone | 215-707-2314
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Fax |
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Provider Business Mailing Address
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Address Line | 3223 N BROAD STREET DEPARTMENT OF ORTHODONTICS
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City | PHILADELPHIA
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State | PA
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Zip | 19140
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Country | US
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Telephone | 215-707-2314
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | RFD000021
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | DS043330
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License Number State | PA
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