Organization
TENDER CARE PEDIATRIC DENTISTRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BEATRIZ DE LA ROCHE D.M.D (OWNER)
(724) 542-4818
Entity
Organization
Contact information
Practice address
6583 ROUTE 819 S, SUITE1, MOUNT PLEASANT, PA 15666-3503
(724) 542-4818
(724) 542-4828
Mailing address
6583 ROUTE 819 S, SUITE1, MOUNT PLEASANT, PA 15666-3503
(724) 542-4818
(724) 542-4828
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DS030164L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000000191199
—
PA
01
—
000271462
UNITED CONCORDIA
PA
01
—
2443009
AETNA DENTAL
PA
Enumeration date
03/28/2007
Last updated
12/13/2011
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