Organization
ARDMORE PEDIATRIC DENTAL ASSOCIATES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAY GOLDSLEGER DMD (PRESIDENT)
(610) 896-8300
Entity
Organization
Contact information
Practice address
233 E LANCASTER AVE, SUITE 201, ARDMORE, PA 19003-2321
(610) 896-8300
Mailing address
596 LANCASTER AVE, SUITE 101, MALVERN, PA 19355-1808
(484) 679-4071
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DS018777L
PA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
DS020687L
PA
Other
Enumeration date
05/19/2016
Last updated
05/19/2016
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