Organization
NORTHEASTERN DENTAL SPECIALIST PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELAINE E BAGGETT (OFFICE MANAGER)
(610) 377-5676
Entity
Organization
Contact information
Practice address
432 S 9TH ST, LEHIGHTON, PA 18235-1812
(610) 377-5676
(610) 377-5673
Mailing address
432 S 9TH ST, LEHIGHTON, PA 18235-1812
(610) 377-5676
(610) 377-5673
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
10/22/2020
Last updated
10/30/2020
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