| Special Care Dental Of Pennsylvania-ckk Llc | |
|
639 Red Lion Rd Huntingdon Valley PA 19006-6216 | |
| (855) 259-9183 | |
| (800) 485-1881 |
| Full Name | Special Care Dental Of Pennsylvania-ckk Llc |
|---|---|
| Speciality | Dentist |
| Location | 639 Red Lion Rd, Huntingdon Valley, Pennsylvania |
| Authorized Official Name and Position | Christopher Krowicki (PRESIDENT) |
| Authorized Official Contact | 8552599183 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Special Care Dental Of Pennsylvania-ckk Llc 639 Red Lion Rd Huntingdon Valley PA 19006-6216 Ph: (855) 259-9183 | Special Care Dental Of Pennsylvania-ckk Llc 639 Red Lion Rd Huntingdon Valley PA 19006-6216 Ph: (855) 259-9183 |
| NPI Number | 1801162219 |
|---|---|
| Provider Enumeration Date | 03/29/2012 |
| Last Update Date | 03/29/2012 |
| Medicare PECOS PAC ID | 9032499744 |
|---|---|
| Medicare Enrollment ID | O20161214001457 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801162219 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DS036946 (Pennsylvania) | Primary |
| Provider Name | Christopher K Krowicki |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1043308646 PECOS PAC ID: 6103106851 Enrollment ID: I20161215000254 |
| Provider Name | Allison J Dillner |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1710374350 PECOS PAC ID: 5698058741 Enrollment ID: I20170215001332 |
| Provider Name | Nicholas J Miller |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1396832226 PECOS PAC ID: 2264715333 Enrollment ID: I20170215002110 |
| Provider Name | Daniel R Seger |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1558626481 PECOS PAC ID: 7517240617 Enrollment ID: I20170216000022 |
| Provider Name | Mark A Ritter |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1235118274 PECOS PAC ID: 9638452733 Enrollment ID: I20170216000236 |
| Provider Name | Robert J Funk |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1033275961 PECOS PAC ID: 0042594004 Enrollment ID: I20170313000084 |
| Provider Name | Edward Mark Pallotta |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1740327253 PECOS PAC ID: 6608166582 Enrollment ID: I20170506000016 |
| Provider Name | Ossama Boulos |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1528346236 PECOS PAC ID: 9931476488 Enrollment ID: I20170605000679 |
| Provider Name | Allen Geng |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1568759330 PECOS PAC ID: 4587932777 Enrollment ID: I20170612001736 |
| Provider Name | Melanie S Morrow |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1932179827 PECOS PAC ID: 1850659749 Enrollment ID: I20171226000511 |
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