# CDA NORTH POCONO LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Century Dental North Pocono
- **Organization subpart:** No

## Provider details

- **NPI number:** 1811694946
- **Authorized official:** DANIELLE WILKES (CONTRACT/CREDENTIALING MANAGER)
- **Authorized official phone:** (570) 876-4488

## Contact information

- **Practice address:** 747 BLUE SHUTTERS RD, ROARING BROOK TWP, PA 18444-7626
- **Practice address phone:** (570) 842-4211
- **Practice address fax:** (570) 842-4211
- **Mailing address:** 747 BLUE SHUTTERS RD, ROARING BROOK TWP, PA 18444-7626
- **Mailing address phone:** (570) 842-4211
- **Mailing address fax:** (570) 842-4211

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 02/09/2023
- **Last updated:** 02/09/2023