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General NPI Number Information
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NPI Number | 1093145872
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Entity Type | Organization
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Legal Business Name | PMAK CHILDREN'S DENTAL, LLC
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Dates
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Enumeration Date | 11/15/2013
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Last Update Date | 11/15/2013
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Provider Practice Location Address
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Address Line | 1517 POND RD SUITE 201
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City | ALLENTOWN
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State | PA
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Zip | 18104-2253
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Country | US
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Telephone | 610-395-4800
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Fax | 610-395-7080
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Provider Business Mailing Address
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Address Line | 1517 POND RD SUITE 201
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City | ALLENTOWN
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State | PA
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Zip | 18104-2253
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Country | US
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Telephone | 610-395-4800
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Fax | 610-395-7080
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Authorized Official
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Title or Position | OWNER
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Name | DR. PHILLIP KNIGHT BRINTON
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Credential | D.D.S.
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Telephone | 646-592-2320
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | DS038628
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License Number State | PA
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