| Pediatric Dental Assoc Ltd | |
|
928 Jaymor Road Suite 130a Southampton PA 18966 | |
| (215) 942-7300 | |
| (215) 942-7386 |
| Full Name | Pediatric Dental Assoc Ltd |
|---|---|
| Speciality | Dentist |
| Location | 928 Jaymor Road, Southampton, Pennsylvania |
| Authorized Official Name and Position | Michael S Rosenbaum (PARTNER) |
| 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 Phila PA 19149 Ph: (215) 743-3700 | Pediatric Dental Assoc Ltd 928 Jaymor Road Suite 130a Southampton PA 18966 Ph: (215) 942-7300 |
| NPI Number | 1902961899 |
|---|---|
| Provider Enumeration Date | 12/22/2006 |
| Last Update Date | 05/30/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902961899 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DS025205L (Pennsylvania) | Secondary |
| 122300000X | Dentist | DS028803L (Pennsylvania) | Primary |
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