Provider Demographics
NPI:1417734187
Name:SOCIETY HILL FAMILY DENTISTRY
Entity Type:Organization
Organization Name:SOCIETY HILL FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:
Authorized Official - Last Name:TUNO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-286-0312
Mailing Address - Street 1:111 S INDEPENDENCE MALL E STE 610
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19106-2509
Mailing Address - Country:US
Mailing Address - Phone:215-238-0800
Mailing Address - Fax:
Practice Address - Street 1:111 S INDEPENDENCE MALL E STE 610
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19106-2509
Practice Address - Country:US
Practice Address - Phone:215-238-0800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-14
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental