Organization
EAGLE CREST PEDIATRIC DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROSE WADENYA DMD (OWNER / PEDIATRIC DENTIST)
(484) 454-3568
Entity
Organization
Contact information
Practice address
31 S EAGLE RD, SUITE 100, HAVERTOWN, PA 19083-3340
(484) 454-3568
(484) 454-3582
Mailing address
31 S EAGLE RD, SUITE 100, HAVERTOWN, PA 19083-3340
(484) 454-3568
(484) 454-3582
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
11/06/2012
Last updated
10/03/2014
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