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Organization

SPROUT PEDIATRIC DENTAL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KATHERINE ROSALIE SCHLOESSER DMD (OWNER)
(570) 253-0358
Entity
Organization

Contact information

Practice address
554 HAMLIN HIGHWAY, LAKE ARIEL, PA 18436-9319
(570) 253-0358
Mailing address
554 HAMLIN HWY, LAKE ARIEL, PA 18436-9319
(570) 253-0358
(570) 253-0751

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
102202080
PA
Enumeration date
09/26/2012
Last updated
03/19/2022
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