| Cda North Pocono Llc | |
|
747 Blue Shutters Rd Roaring Brook Twp PA 18444-7626 | |
| (570) 842-4211 | |
| (570) 842-4211 |
| Full Name | Cda North Pocono Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 747 Blue Shutters Rd, Roaring Brook Twp, Pennsylvania |
| Authorized Official Name and Position | Danielle Wilkes (CONTRACT/CREDENTIALING MANAGER) |
| Authorized Official Contact | 5708764488 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cda North Pocono Llc 747 Blue Shutters Rd Roaring Brook Twp PA 18444-7626 Ph: (570) 842-4211 | Cda North Pocono Llc 747 Blue Shutters Rd Roaring Brook Twp PA 18444-7626 Ph: (570) 842-4211 |
| NPI Number | 1811694946 |
|---|---|
| Provider Enumeration Date | 02/09/2023 |
| Last Update Date | 02/09/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811694946 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |