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General NPI Number Information
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NPI Number | 1568107167
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Entity Type | Organization
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Legal Business Name | KID'S CHOICE DENTAL LLC
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Dates
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Enumeration Date | 04/28/2022
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Last Update Date | 04/28/2022
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Provider Practice Location Address
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Address Line | 2137 WELSH RD # 1C1E
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City | PHILADELPHIA
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State | PA
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Zip | 19115-4963
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Country | US
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Telephone | 267-261-6842
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Fax |
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Provider Business Mailing Address
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Address Line | 11126 DRAKE DR
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City | PHILADELPHIA
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State | PA
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Zip | 19154-3608
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Country | US
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Telephone | 215-317-4122
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. ERIN MCGRATH
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Credential | DMD
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Telephone | 215-317-4122
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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 |
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License Number State |
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