MEDICARE: DR. PHILIP NICHOLAS CALABRIA 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
1	1223G0001X	General Practice Dentistry	DS016654L	PA

General Provider Information

NPI Number	:	1508078841
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PHILIP NICHOLAS CALABRIA DDS

Provider Business Mailing Address
First Line	:	672 MAIN ST
Second Line	:
City	:	HARLEYSVILLE
State	:	PA
Zip	:	19438-1679
Country	:	US
Telephone Number	:	215-513-9533
Fax Number	:	215-513-6274

Provider Business Practice Location Address
First Line	:	672 MAIN ST
Second Line	:
City	:	HARLEYSVILLE
State	:	PA
Zip	:	19438-1679
Country	:	US
Telephone Number	:	215-513-9533
Fax Number	:	215-513-6274

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

Provider Enumeration Date	:	05/07/2007
Last Update Date	:	07/08/2007

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