Organization
PREMIER DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DIANE C HERNANDEZ D.M.D. (OWNER)
(610) 869-6055
Entity
Organization
Contact information
Practice address
390 VINEYARD WAY, SUITE 505, WEST GROVE, PA 19390-8835
(610) 869-0655
(610) 869-6099
Mailing address
390 VINEYARD WAY, SUITE 505, WEST GROVE, PA 19390-8835
(610) 869-0655
(610) 869-6099
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS036040
PA
Other
Enumeration date
08/09/2007
Last updated
08/09/2007
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