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General NPI Number Information
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NPI Number | 1801377239
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Entity Type | Organization
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Legal Business Name | DENTISTRY4KIDS, LLC
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Dates
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Enumeration Date | 08/23/2018
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Last Update Date | 08/23/2018
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Provider Practice Location Address
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Address Line | 2075 BYBERRY RD STE 101
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City | BENSALEM
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State | PA
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Zip | 19020-3859
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Country | US
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Telephone | 214-244-4335
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Fax |
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Provider Business Mailing Address
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Address Line | 2075 BYBERRY RD STE 101
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City | BENSALEM
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State | PA
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Zip | 19020-3859
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Country | US
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Telephone | 214-244-4335
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | JESSICA WINKLER
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Credential |
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Telephone | 215-244-4335
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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