Organization
CHESTER COUNTY COMMUNITY DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MICHELE C PARKER (OFFICE MANAGER)
(610) 383-3888
Entity
Organization
Contact information
Practice address
1131 OLIVE STREET, COATESVILLE, PA 19320
(610) 383-3888
(610) 383-4688
Mailing address
1131 OLIVE STREET, COATESVILLE, PA 19320
(610) 383-3888
(610) 383-4688
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
DS035533
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0019188310003
—
PA
Enumeration date
12/01/2006
Last updated
08/22/2020
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