| Tied Main Line Tongue Tie Professionals. | |
|
1125 Lancaster Ave Ste 2 Berwyn PA 19312-2601 | |
| (610) 557-0252 | |
| (610) 557-0253 |
| Full Name | Tied Main Line Tongue Tie Professionals. |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 1125 Lancaster Ave Ste 2, Berwyn, Pennsylvania |
| Authorized Official Name and Position | Jacqueline Palma Wingate (OWNER) |
| Authorized Official Contact | 6105570252 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tied Main Line Tongue Tie Professionals. 1125 Lancaster Ave Ste 2 Berwyn PA 19312-2601 Ph: (610) 557-0252 | Tied Main Line Tongue Tie Professionals. 1125 Lancaster Ave Ste 2 Berwyn PA 19312-2601 Ph: (610) 557-0252 |
| NPI Number | 1255163341 |
|---|---|
| Provider Enumeration Date | 08/16/2024 |
| Last Update Date | 08/16/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255163341 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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