# LEHIGH VALLEY SUBURBAN DENTAL ASSOC LTD

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Suburban Dental Associates
- **Organization subpart:** No

## Provider details

- **NPI number:** 1437269008
- **Authorized official:** DR. MARK B DIAMOND DMD (PARTNER MANAGER)
- **Authorized official phone:** (610) 820-9900

## Contact information

- **Practice address:** 1621 N CEDARCREST BLVD, SUITE 117, ALLENTOWN, PA 18104
- **Practice address phone:** (610) 820-9900
- **Practice address fax:** (610) 820-9922
- **Mailing address:** 1621 N CEDARCREST BLVD, SUITE 117, ALLENTOWN, PA 18104
- **Mailing address phone:** (610) 820-9900
- **Mailing address fax:** (610) 820-9922

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | DS017121L | PA | — |
| 122300000X | Dentist | DS019952L | PA | — |
| 122300000X | Dentist | DS020511L | PA | Yes |
| 122300000X | Dentist | DS022795L | PA | — |

## Other

- **Enumeration date:** 08/30/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 10274 | AETNA | PA |
| 01 | — | 414531 | UNITED CONCORDIA UCCI | PA |