| Pediatric Dental Assoc., Ltd | |
|
6404 Roosevelt Blvd Philadelphia PA 19149-2943 | |
| (215) 743-3700 | |
| (215) 743-3706 |
| Full Name | Pediatric Dental Assoc., Ltd |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 6404 Roosevelt Blvd, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Joanne Coll (INSURANCE COORDINATOR) |
| Authorized Official Contact | 2157433700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pediatric Dental Assoc., Ltd 6404 Roosevelt Blvd Philadelphia PA 19149-2943 Ph: (215) 743-3700 | Pediatric Dental Assoc., Ltd 6404 Roosevelt Blvd Philadelphia PA 19149-2943 Ph: (215) 743-3700 |
| NPI Number | 1538231220 |
|---|---|
| Provider Enumeration Date | 11/15/2006 |
| Last Update Date | 05/30/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538231220 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | DS018048L (Pennsylvania) | Primary |
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