Organization
PEDIATRIC DENTAL ASSOC., LTD
Active
Parent organization
PEDIATRIC DENTAL ASSOCIATES, LTD
Organization subpart
Yes
Provider details
NPI number
Legal business name
PEDIATRIC DENTAL ASSOCIATES, LTD
Authorized official
MRS. JOANNE COLL (INSURANCE COORDINATOR)
(215) 743-3700
Entity
Organization
Contact information
Practice address
6404 ROOSEVELT BLVD, PHILADELPHIA, PA 19149-2943
(215) 743-3700
(215) 743-3706
Mailing address
6404 ROOSEVELT BLVD, PHILADELPHIA, PA 19149-2943
(215) 743-3700
(215) 743-3706
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DS018048L
PA
Other
Enumeration date
11/15/2006
Last updated
05/30/2008
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