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Organization
PEDIATRIC DENTAL ASSOC LTD
Active
Organization
PEDIATRIC DENTAL ASSOC LTD
Active
Parent organization
PEDIATRIC DENTAL ASSOCIATES LTD
Organization subpart
Yes
Provider details
NPI number
Legal business name
PEDIATRIC DENTAL ASSOCIATES LTD
Authorized official
MICHAEL S ROSENBAUM DMD (PARTNER)
(215) 743-3700
Entity
Organization
Contact information
Practice address
928 JAYMOR ROAD, SUITE 130A, SOUTHAMPTON, PA 18966
(215) 942-7300
(215) 942-7386
Mailing address
6404 ROOSEVELT BLVD, PHILA, PA 19149
(215) 743-3700
(215) 743-3715
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DS025205L
PA
122300000X
Dentist
Primary
DS028803L
PA
Other
Enumeration date
12/22/2006
Last updated
05/30/2008
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