Organization
PEDIATRIC DENTAL ASSOCIATES LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JOANNE COLL (INSURANCE MANAGER)
(215) 743-3700
Entity
Organization
Contact information
Practice address
6404 ROOSEVELT BLVD, LOWER LEVEL, PHILADELPHIA, PA 19149-2943
(215) 743-3700
(215) 743-3715
Mailing address
6404 ROOSEVELT BLVD, LOWER LEVEL, PHILADELPHIA, PA 19149-2943
(215) 743-3700
(215) 743-3715
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DS025205L
PA
Other
Enumeration date
05/30/2008
Last updated
03/15/2012
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