Provider Demographics
NPI:1750498382
Name:CHILA, MARIA C (DMD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:C
Last Name:CHILA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 S JUNIPER ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19148-5246
Mailing Address - Country:US
Mailing Address - Phone:215-334-4644
Mailing Address - Fax:
Practice Address - Street 1:100 CHURCH RD
Practice Address - Street 2:SUITE 302
Practice Address - City:ARDMORE
Practice Address - State:PA
Practice Address - Zip Code:19003-2316
Practice Address - Country:US
Practice Address - Phone:610-642-0185
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADSO24616L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice