Individual provider · Type 1 NPI
Soumya Immella, DMD
Pediatric Dentistry · Breinigsville, PA
NPI number
1306480298
Active
Practice location
1536 Crossland Rd
Breinigsville, PA 18031-1471
Fax (610) 435-7606
Mailing address
750 N Krocks Rd Ste 206
Allentown, PA 18106-9079
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pediatric Dentistry Primary | 1223P0221X | DS042399 (PA) |
Pediatric Dentistry: An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
About NPI 1306480298
Soumya Immella, DMD's National Provider Identifier is 1306480298, issued on Nov 4, 2019. The primary taxonomy on file is Pediatric Dentistry (1223P0221X), and the practice location is in Breinigsville, PA. The record was last updated on Mar 1, 2024.