MEDICARE: DR. RENEE YUROVSKY 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	122300000X	Dentist	DS031579L	PA
2	122300000X	Dentist	DI02281600	NJ

General Provider Information

NPI Number	:	1841341732
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RENEE YUROVSKY DDS

Provider Business Mailing Address
First Line	:	1831 CHESTNUT ST.
Second Line	:	SUITE 100
City	:	PHILADELPHIA
State	:	PA
Zip	:	19103
Country	:	US
Telephone Number	:	215-545-1202
Fax Number	:	215-545-1239

Provider Business Practice Location Address
First Line	:	1831 CHESTNUT ST
Second Line	:	SUITE 100
City	:	PHILADELPHIA
State	:	PA
Zip	:	19103-3713
Country	:	US
Telephone Number	:	215-545-1202
Fax Number	:	215-545-1239

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

Provider Enumeration Date	:	01/16/2007
Last Update Date	:	12/11/2009

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