Charm Pediatric Dentistry, Llc | |
1040 Dekalb Pike Suite 100 Blue Bell PA 19422 | |
(610) 277-4811 | |
(610) 277-4896 |
Full Name | Charm Pediatric Dentistry, Llc |
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Speciality | Dentist - Pediatric Dentistry |
Location | 1040 Dekalb Pike, Blue Bell, Pennsylvania |
Authorized Official Name and Position | Yoosung Suh (OWNER) |
Authorized Official Contact | 6102774811 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Charm Pediatric Dentistry, Llc 1040 Dekalb Pike Suite 100 Blue Bell PA 19422-1812 Ph: (610) 277-4811 | Charm Pediatric Dentistry, Llc 1040 Dekalb Pike Suite 100 Blue Bell PA 19422 Ph: (610) 277-4811 |
NPI Number | 1649439613 |
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Provider Enumeration Date | 06/05/2008 |
Last Update Date | 05/05/2015 |
Identifier | Type | State | Issuer |
---|---|---|---|
1649439613 | NPI | - | NPPES |
102099918001 | Medicaid | PA | |
1831119916 | Other | PA | NPI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223P0221X | Dentist - Pediatric Dentistry | DS030062L (Pennsylvania) | Primary |
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