MEDICARE: DR. JOSEPH B BREITMAN 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	1223P0700X	Prosthodontics	DS-020416-L	PA

General Provider Information

NPI Number	:	1932213287
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH B BREITMAN D.M.D

Provider Business Mailing Address
First Line	:	8021-B CASTOR AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19152
Country	:	US
Telephone Number	:	215-728-1696
Fax Number	:	215-745-8811

Provider Business Practice Location Address
First Line	:	8021 CASTOR AVE
Second Line	:	SUITE B
City	:	PHILADELPHIA
State	:	PA
Zip	:	19152-2733
Country	:	US
Telephone Number	:	215-728-1696
Fax Number	:	215-745-8811

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

Provider Enumeration Date	:	08/17/2006
Last Update Date	:	07/08/2007

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