MEDICARE: DR. JOSEPH SALKOWITZ D.M.D.

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	DS019999L	PA
2	1223G0001X	General Practice Dentistry	22D101206200	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	020042	OTHER	PA	UNITED CONCORDIA

General Provider Information

NPI Number	:	1356343438
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH SALKOWITZ D.M.D.

Provider Business Mailing Address
First Line	:	255 S 17TH ST
Second Line	:	STE 1201
City	:	PHILADELPHIA
State	:	PA
Zip	:	19103-6212
Country	:	US
Telephone Number	:	215-735-0180
Fax Number	:	215-735-8578

Provider Business Practice Location Address
First Line	:	255 S 17TH ST
Second Line	:	STE 1201
City	:	PHILADELPHIA
State	:	PA
Zip	:	19103-6212
Country	:	US
Telephone Number	:	215-735-0180
Fax Number	:	215-735-8578

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

Provider Enumeration Date	:	06/02/2005
Last Update Date	:	07/08/2007

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