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Search › Pennsylvania › 390200000X

Sara Supriyatno, DDS

NPI 1225775778 · on the registry since 2022

Practice

Address
909 Walnut St Rm 300
Philadelphia, PA 19107
Phone
(215) 503-7118
Fax
(215) 923-9189
Organisation at this address
David S. Poll, M.D., Pc
Thomas Jefferson University
Thomas Jefferson University Hospital
Methodist Associates In Healthcare, Inc
Methodist Associates In Healthcare, Inc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
180

Registry record

Primary taxonomy
390200000X
390200000X
Also registered as
1223G0001X
Licence states on file
PA
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2024-01-09

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Pennsylvania