MEDICARE: LINDSEY CERDAS DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	DS041294	PA

General Provider Information

NPI Number	:	1003344631
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDSEY CERDAS DMD

Provider Business Mailing Address
First Line	:	424 QUIGLEY AVE
Second Line	:
City	:	WILLOW GROVE
State	:	PA
Zip	:	19090-3608
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 NORTH ST
Second Line	:
City	:	DOYLESTOWN
State	:	PA
Zip	:	18901-3837
Country	:	US
Telephone Number	:	215-348-3676
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/26/2017
Last Update Date	:	05/26/2017

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