Organization
COLLEGEVILLE PEDIATRIC DENTISTRY P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANE O'BRIEN (BUSINESS MANAGER)
(610) 962-0193
Entity
Organization
Contact information
Practice address
555 SECOND AVE, SUITE E202, COLLEGEVILLE, PA 19426-3600
(610) 962-0193
Mailing address
555 SECOND AVE, SUITE E202, COLLEGEVILLE, PA 19426-3600
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
03/20/2017
Last updated
03/20/2017
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