PA SURGERY GROUP LLC NPI 1891477162

NPI Information

  • NPI: 1891477162
  • Provider Name: PA SURGERY GROUP LLC
  • Classification: Dentist - 1223S0112X
  • Specialization: Oral and Maxillofacial Surgery
  • Entity Type: Organization
  • Address: 1528 WALNUT ST STE 200
    PHILADELPHIA, PA
    ZIP 19102
  • Phone: (215) 515-2881

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NPI Details

PA SURGERY GROUP LLC is an oral and maxillofacial surgery dentist in Philadelphia, PA. The provider is an oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. PA SURGERY GROUP LLC NPI is 1891477162. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1528 WALNUT ST STE 200
PHILADELPHIA, PA
ZIP 19102-602
Phone: (215) 515-2881

The provider's authorized official is Ali Mohammad .
The authorized official title is Surgeon and has the following contact phone number (917) 330-0939.

The enumeration date for this NPI number is 8/4/2023 and was last updated on 10/15/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223S0112XDentistOral and Maxillofacial SurgeryYes

What is NPI?

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This page was last updated on: 3/30/2025

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