Organization
POTTSVILLE PEDIATRIC DENTAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PRECIOSA PEREZ DDS (PARTNER)
(570) 622-7430
Entity
Organization
Contact information
Practice address
305 N 2ND ST, POTTSVILLE, PA 17901-2503
(570) 622-7430
Mailing address
305 N 2ND ST, POTTSVILLE, PA 17901-2503
(570) 622-7430
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DS031182L
PA
1223P0221X
Pediatric Dentistry
Primary
DS035069
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001883048-0001
—
PA
Enumeration date
03/15/2011
Last updated
03/15/2011
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