MEDICARE: DR. CHIARA QUICK D.D.S.

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	1223E0200X	Endodontics	DS041620	PA

General Provider Information

NPI Number	:	1467834937
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHIARA QUICK D.D.S.

Provider Business Mailing Address
First Line	:	300 ALEXANDER CT APT 110
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19103-1156
Country	:	US
Telephone Number	:	480-282-2526
Fax Number	:

Provider Business Practice Location Address
First Line	:	1517 PACKER AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19145-4910
Country	:	US
Telephone Number	:	215-618-9070
Fax Number	:

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

Provider Enumeration Date	:	06/22/2015
Last Update Date	:	04/28/2024

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