Provider Demographics
NPI:1427138437
Name:IERARDI, PATRICE (DMD)
Entity type:Individual
Prefix:DR
First Name:PATRICE
Middle Name:
Last Name:IERARDI
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 1:21 S 5TH ST
Mailing Address - Street 2:SUITE 610
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19106-2515
Mailing Address - Country:US
Mailing Address - Phone:215-238-0800
Mailing Address - Fax:215-413-0377
Practice Address - Street 1:21 S 5TH ST
Practice Address - Street 2:SUITE 610
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19106-2515
Practice Address - Country:US
Practice Address - Phone:215-238-0800
Practice Address - Fax:215-413-0377
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2010-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS024194L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice