| Sprout Pediatric Dental | |
|
487 Northampton St Kingston PA 18704-4509 | |
| (267) 324-7933 | |
| (570) 352-3395 |
| Full Name | Sprout Pediatric Dental |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 487 Northampton St, Kingston, Pennsylvania |
| Authorized Official Name and Position | Katherine Rosalie Schloesser (PEDIATRIC DENTIST) |
| Authorized Official Contact | 5702530358 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sprout Pediatric Dental 554 Hamlin Hwy Lake Ariel PA 18436-9319 Ph: (267) 324-7933 | Sprout Pediatric Dental 487 Northampton St Kingston PA 18704-4509 Ph: (267) 324-7933 |
| NPI Number | 1558080804 |
|---|---|
| Provider Enumeration Date | 08/22/2022 |
| Last Update Date | 08/22/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558080804 | NPI | - | NPPES |
| 102769720-0003 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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