Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | DS019952-L | PA |
NPI | 1124249750 |
---|---|
Provider Name | Dr. Edward L. Woehling |
First Address | Rosemont, PA 19010-2636 |
Second Address | Rosemont, PA 19010-2636 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2007 |
Last Update Date | 08/07/2007 |