Organization
CRENTIST PC
Active
Other names
Ridley Dental Center
Organization subpart
No
Provider details
NPI number
Authorized official
JORDAN KLINKNER (PRESIDENT)
(917) 523-9800
Entity
Organization
Contact information
Practice address
1100 MACDADE BLVD, WOODLYN, PA 19094-1322
(610) 833-1919
Mailing address
1100 MACDADE BLVD, WOODLYN, PA 19094-1322
(610) 833-1919
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
12/07/2019
Last updated
12/07/2019
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