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NPI Code Detail

MEDICARE: DR. PHILIP T. SIEGEL DDS

MEDICARE: DR. PHILIP T. SIEGEL DDS
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
11223X0400XOrthodontics and Dentofacial Orthopedics DentistryDSO17273PA

General Provider Information

NPI Number : 1164402004
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PHILIP T. SIEGEL DDS
Provider Business Mailing Address
First Line : 6404 ROOSEVELT BLVD
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19149-2943
Country : US
Telephone Number : 215-743-3700
Fax Number : 215-743-3706
Provider Business Practice Location Address
First Line : 6404 ROOSEVELT BLVD
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19149-2943
Country : US
Telephone Number : 215-743-3700
Fax Number : 215-743-3706
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/18/2006
Last Update Date : 07/08/2007

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Directions to “ DR. PHILIP T. SIEGEL DDS” Practice Location

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