Individual provider · Type 1 NPI

Sara Supriyatno, DDS

Student in an Organized Health Care Education/Training Program · Philadelphia, PA

NPI number 1225775778 Active

Practice location

909 Walnut St Rm 300
Philadelphia, PA 19107-5211

Call (215) 503-7118 Map

Fax (215) 923-9189

Specialties and licenses

TaxonomyCodeLicense
General Practice Dentistry 1223G0001XDS043687 (PA)
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

12 other providers at this address

Other student in an organized health care education/training program providers in Philadelphia

See all in Philadelphia →

About NPI 1225775778

Sara Supriyatno, DDS's National Provider Identifier is 1225775778, issued on May 17, 2022. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Philadelphia, PA. The record was last updated on Jan 9, 2024.