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Organization

KIDDOS PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MARILOU DIBAGNO (OFFICE MANAGER)
(724) 542-4818
Entity
Organization

Contact information

Practice address
6583 STATE ROUTE 819 S STE 1, MT PLEASANT, PA 15666-3503
(724) 542-4818
(724) 542-4828
Mailing address
6583 STATE ROUTE 819 S STE 1, MT PLEASANT, PA 15666-3503
(724) 542-4818
(724) 542-4828

Taxonomy

Speciality
Code
Description
License number
State
1223D0004X
Dental Anesthesiology
DS035406
PA
1223P0221X
Pediatric Dentistry
Primary
DS030164L
PA

Other

Enumeration date
08/31/2017
Last updated
07/21/2022
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