| Pediatric Dentistry | |
|
1517 Pond Rd Suite 201 Allentown PA 18104-2253 | |
| (610) 395-4800 | |
| (610) 395-7080 |
| Full Name | Pediatric Dentistry |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 1517 Pond Rd, Allentown, Pennsylvania |
| Authorized Official Name and Position | Phillip Knight Brinton (OWNER) |
| Authorized Official Contact | 6465922320 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pediatric Dentistry 1517 Pond Rd Suite 201 Allentown PA 18104-2253 Ph: (610) 395-4800 | Pediatric Dentistry 1517 Pond Rd Suite 201 Allentown PA 18104-2253 Ph: (610) 395-4800 |
| NPI Number | 1093145872 |
|---|---|
| Provider Enumeration Date | 11/15/2013 |
| Last Update Date | 11/15/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093145872 | NPI | - | NPPES |
| 1025976520008 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | DS038628 (Pennsylvania) | Primary |
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