DR. Robert J Diecidue, DMD, MD

NPI #1225069818 in Philadelphia, Pennsylvania

Provider Information

NPI Number: 1225069818
Entity Type: Individual
Name: DR. Robert J Diecidue, DMD, MD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Oral & Maxillofacial Surgery
Credential: DMD, MD
Enumeration Date: Jul 5, 2006
Last Updated: Aug 23, 2019

Practice Location

Address: 909 WALNUT ST
Address 2: 3RD FLOOR, COB
City: Philadelphia
State: Pennsylvania
ZIP Code: 19107-5211
Phone: (215) 955-6215

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - Oral and Maxillofacial Surgery — Oral and Maxillofacial Surgery	1223S0112X
Oral & Maxillofacial Surgery	204E00000X	Primary

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