MEDICARE: DR. JOHN STEPHEN HORCHOS 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	1223P0221X	Pediatric Dentistry	D5028631L	PA

General Provider Information

NPI Number	:	1225045974
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN STEPHEN HORCHOS DMD

Provider Business Mailing Address
First Line	:	1916 WELSH RD
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19115-4655
Country	:	US
Telephone Number	:	215-676-2311
Fax Number	:

Provider Business Practice Location Address
First Line	:	1916 WELSH RD
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19115-4655
Country	:	US
Telephone Number	:	215-676-2311
Fax Number	:

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

Provider Enumeration Date	:	08/02/2006
Last Update Date	:	07/08/2007

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