Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 22DI02197700 | NJ |
N | 1223P0221X | Pediatric Dentist | DS036117 | PA |
NPI | 1063406403 |
---|---|
Provider Name | Dr. Susan Adele Armstrong |
First Address | Moorestown, NJ 08057-3382 |
Second Address | Moorestown, NJ 08057-3382 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2005 |
Last Update Date | 15/01/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
101201070 | (05) | PA |