Individual
BEATRIZ DE LA ROCHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DS030164L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000000191199
—
PA
01
—
000271462
UNITED CONCORDIA
PA
01
—
2443009
AETNA DENTAL
PA
Enumeration date
04/25/2007
Last updated
12/13/2011
Update your record
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