MEDICARE: DR. EUGENE N TALMADGE DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	22DI02974200	NJ

General Provider Information

NPI Number	:	1114619160
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EUGENE N TALMADGE DMD

Provider Business Mailing Address
First Line	:	718 N 17TH ST APT 201
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19130-2819
Country	:	US
Telephone Number	:	347-324-6275
Fax Number	:

Provider Business Practice Location Address
First Line	:	1817 MOUNT HOLLY RD
Second Line	:
City	:	BURLINGTON
State	:	NJ
Zip	:	08016-4700
Country	:	US
Telephone Number	:	609-267-4200
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/25/2023
Last Update Date	:	05/25/2023

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