Organization
ACCESS DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHEEBA SHAJU DDS (DENTAL DIRECTOR)
(484) 237-4054
Entity
Organization
Contact information
Practice address
340 COMMONS DR, PARKESBURG, PA 19365-2154
(484) 237-4054
Mailing address
18 MADISON WAY, DOWNINGTOWN, PA 19335-5329
(484) 237-4054
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS038352
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1659683464
NPI
PA
Enumeration date
07/29/2012
Last updated
07/29/2012
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