NPI 1225069818

Robert J Diecidue, DMDMD

Practitioner Oral & Maxillofacial Surgery (D.M.D.) Philadelphia, PA

Practice location

Address: 909 Walnut St 3rd Floor, Cob, Philadelphia, PA 19107-5211
Phone: (215) 955-6215
Fax: (215) 923-9189

Registered specialties (2)

Oral & Maxillofacial Surgery (D.M.D.) Primary

Allopathic & Osteopathic Physicians Taxonomy 204E00000X Licence MD421272 (PA)

Other Oral & Maxillofacial Surgery providers in Pennsylvania →

Oral and Maxillofacial Surgery (Dentist)

Dental Providers Taxonomy 1223S0112X Licence DS026243L (PA)

Other Dentist providers in Pennsylvania →

Registry record

NPI: 1225069818
Entity type: Individual
Sex (as registered): Male
NPI issued: 5 Jul 2006
Record last updated: 23 Aug 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.