MEDICARE: DR. MARIA C CHILA 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	DSO24616L	PA

General Provider Information

NPI Number	:	1750498382
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARIA C CHILA D.M.D.

Provider Business Mailing Address
First Line	:	3100 S JUNIPER ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19148-5246
Country	:	US
Telephone Number	:	215-334-4644
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 CHURCH RD
Second Line	:	SUITE 302
City	:	ARDMORE
State	:	PA
Zip	:	19003-2316
Country	:	US
Telephone Number	:	610-642-0185
Fax Number	:

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

Provider Enumeration Date	:	08/23/2006
Last Update Date	:	07/08/2007

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