Organization
BALA KIDS DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA WAXMAN (OFFICE MANAGER)
(610) 667-6161
Entity
Organization
Contact information
Practice address
15 N PRESIDENTIAL BLVD, SUITE 303, BALA CYNWYD, PA 19004-1006
(610) 336-8478
(610) 617-9275
Mailing address
15 N PRESIDENTIAL BLVD, SUITE 303, BALA CYNWYD, PA 19004-1006
(610) 336-8478
(610) 617-9275
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DS040852
PA
Other
Enumeration date
04/17/2017
Last updated
04/17/2017
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