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NPI Code Detail

MEDICARE: DR. LEONARD FREDRIC TAU DMD

MEDICARE: DR. LEONARD FREDRIC TAU 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
11223G0001XGeneral Practice DentistryDS-031087-LPA

General Provider Information

NPI Number : 1831218825
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LEONARD FREDRIC TAU DMD
Provider Business Mailing Address
First Line : 11905 BUSTLETON AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19116-2541
Country : US
Telephone Number : 215-969-4400
Fax Number : 215-969-4405
Provider Business Practice Location Address
First Line : 11905 BUSTLETON AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19116-2541
Country : US
Telephone Number : 215-969-4400
Fax Number : 215-969-4405
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2007
Last Update Date : 07/08/2007

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