Pediatric Dental Assoc Ltd

LBN: Pediatric Dental Assoc Ltd
Pediatric Dental Assoc Ltd is an health care organization with primary practice located at 3509 N Broad St 6Th Fl W, Philadelphia PA 19140. The organization recently has only one registered license in Dental Providers / Dentist, which is considered as the primary health care specialty. Pediatric Dental Assoc Ltd can be contacted via phone (215) 707-6411, or through Rosenbaum, Michael S via phone (218) 743-3700.

Contact Information

Primary practice address
3509 N Broad St 6Th Fl W Philadelphia PA 19140
Phone: (215) 707-6411
Fax: (215) 707-6417
Website:
Map and Directions
Authorized official contact:
Name: Rosenbaum, Michael S Doctor of Dental Medicine (DMD)
Phone: (218) 743-3700

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X DS025205L Pennsylvania

Profile Details

NPI number 1386708121
LBN Legal business name Pediatric Dental Assoc Ltd
DBA Doing business as
Authorized official Rosenbaum, Michael S Doctor of Dental Medicine (DMD)
Entity Organization
Organization subpart 1 Yes
Enumeration date Dec 19th, 2006
Last updated May 30th, 2008 - about 18 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1386708121 NPPES
Pennsylvania MEDICAID 0005297280003

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