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801 Ostrum St Bethlehem PA 18015-1000 | |
| (484) 526-2460 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 801 Ostrum St, Bethlehem, Pennsylvania |
| Authorized Official Name and Position | Sue Chiavaroli (ENROLLMENT MANAGER) |
| Authorized Official Contact | 4845263569 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
801 Ostrum St Bethlehem PA 18015-1000 Ph: (845) 262-4604 | 801 Ostrum St Bethlehem PA 18015-1000 Ph: (484) 526-2460 |
| NPI Number | 1952581431 |
|---|---|
| Provider Enumeration Date | 11/13/2007 |
| Last Update Date | 08/01/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952581431 | NPI | - | NPPES |
| 1007552510077 | Medicaid | PW |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Secondary |
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