Provider Demographics
NPI:1801377239
Name:DENTISTRY4KIDS, LLC
Entity Type:Organization
Organization Name:DENTISTRY4KIDS, LLC
Other - Org Name:DENTISTRY4KIDS
Other - Org Type:Other Name
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:WINKLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-244-4335
Mailing Address - Street 1:2075 BYBERRY RD STE 101
Mailing Address - Street 2:
Mailing Address - City:BENSALEM
Mailing Address - State:PA
Mailing Address - Zip Code:19020-3859
Mailing Address - Country:US
Mailing Address - Phone:214-244-4335
Mailing Address - Fax:
Practice Address - Street 1:2075 BYBERRY RD STE 101
Practice Address - Street 2:
Practice Address - City:BENSALEM
Practice Address - State:PA
Practice Address - Zip Code:19020-3859
Practice Address - Country:US
Practice Address - Phone:214-244-4335
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-23
Last Update Date:2018-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental