Individual
SUSAN E CALDERBANK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
43 CLINTON ST, GREENVILLE, PA 16125
(724) 588-1600
(724) 588-1608
Mailing address
43 CLINTON ST, GREENVILLE, PA 16125
(724) 588-1600
(724) 588-1608
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS020035L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000891546001
—
PA
01
—
033587
BLUE SHIELD
—
Enumeration date
10/12/2006
Last updated
07/08/2007
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