Organization
TIED MAIN LINE TONGUE TIE PROFESSIONALS.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELINE PALMA WINGATE DMD (OWNER)
(610) 557-0252
Entity
Organization
Contact information
Practice address
1125 LANCASTER AVE STE 2, BERWYN, PA 19312-2601
(610) 557-0252
(610) 557-0253
Mailing address
1125 LANCASTER AVE STE 2, BERWYN, PA 19312-2601
(610) 557-0252
(610) 557-0253
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
08/16/2024
Last updated
08/16/2024
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