Organization
SCHOOLHOUSE ORTHODONTICS LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TASHA W BOLDEN D.M.D, M.S.D (PRESIDENT)
(484) 293-0744
Entity
Organization
Contact information
Practice address
611 NAZARETH PIKE, NAZARETH, PA 18064-9002
(484) 293-0744
Mailing address
611 NAZARETH PIKE, NAZARETH, PA 18064-9002
(484) 293-0744
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1034058100001
—
PA
Enumeration date
07/10/2019
Last updated
07/10/2019
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