Organization
CHARM PEDIATRIC DENTISTRY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. YOOSUNG SUH D.M.D. (OWNER)
(610) 277-4811
Entity
Organization
Contact information
Practice address
1040 DEKALB PIKE, SUITE 100, BLUE BELL, PA 19422
(610) 277-4811
(610) 277-4896
Mailing address
1040 DEKALB PIKE, SUITE 100, BLUE BELL, PA 19422-1812
(610) 277-4811
(610) 277-4896
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DS030062L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102099918001
—
PA
01
—
1831119916
NPI
PA
Enumeration date
06/05/2008
Last updated
05/05/2015
Update your record
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