Organization
CHILDREN AND TEEN DENTAL GROUP OF PENNSYLVANIA PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN SMITH (CFO)
(770) 231-5348
Entity
Organization
Contact information
Practice address
400 MCFARLAN RD, STE 200, KENNETT SQUARE, PA 19348-2477
(610) 925-5700
Mailing address
400 MCFARLAN RD, STE 200, KENNETT SQUARE, PA 19348-2477
(610) 925-5700
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
09/20/2016
Last updated
09/20/2016
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