Premier Dental of Edgmont Square LLC
NPI #1801327002 in Newtown Square, Pennsylvania
Provider Information
- NPI Number
- 1801327002
- Entity Type
- Organization
- Organization Name
- Premier Dental of Edgmont Square LLC
- Primary Specialty
- Dentist
- Enumeration Date
- Mar 21, 2017
- Last Updated
- Apr 24, 2017
Practice Location
- Address
- 4753 W CHESTER PIKE
- City
- Newtown Square
- State
- Pennsylvania
- ZIP Code
- 19073-2212
- Phone
- (484) 424-0078
Authorized Official
- Name
- MIKE COLE
- Title
- VP INSURANCE PLAN MANAGEMENT
- Phone
- (941) 955-3150
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist |
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