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General NPI Number Information
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NPI Number | 1902134422
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Entity Type | Individual
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Provider Name | PHILIP EBDLAHAD DDS
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Gender | Male
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Dates
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Enumeration Date | 11/20/2009
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Last Update Date | 02/28/2014
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Provider Practice Location Address
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Address Line | 236 N 5TH ST
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City | READING
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State | PA
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Zip | 19601-3325
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Country | US
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Telephone | 610-478-9044
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Fax | 610-478-9401
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Provider Business Mailing Address
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Address Line | 236 N 5TH ST
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City | READING
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State | PA
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Zip | 19601-3325
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Country | US
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Telephone | 610-478-9044
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Fax | 610-478-9401
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | DS028620L
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License Number State | PA
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