Provider Demographics
NPI:1487710422
Name:HUGH J ODONNELL JR DDS PC PEDIATRIC DENTISTRY
Entity type:Organization
Organization Name:HUGH J ODONNELL JR DDS PC PEDIATRIC DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HUGH
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:ODONNELL
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:610-433-2357
Mailing Address - Street 1:3057 COLLEGE HEIGHTS BLVD
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-4875
Mailing Address - Country:US
Mailing Address - Phone:610-433-2357
Mailing Address - Fax:610-433-9133
Practice Address - Street 1:3057 COLLEGE HEIGHTS BLVD
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-4875
Practice Address - Country:US
Practice Address - Phone:610-433-2357
Practice Address - Fax:610-433-9133
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0194371223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty