# BETHANY SERAFIN AWALT, DMD, PA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Valley Village Oral Surgery Associates
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376861088
- **Authorized official:** DR. BETHANY S AWALT DMD (OWNER)
- **Authorized official phone:** (410) 581-9008

## Contact information

- **Practice address:** 2 RESERVOIR CIRCLE, SUITE 103, PIKESVILLE, MD 21208
- **Practice address phone:** (410) 581-9008
- **Practice address fax:** (410) 581-6720
- **Mailing address:** 2 RESERVOIR CIRCLE, SUITE 103, PIKESVILLE, MD 21208
- **Mailing address phone:** (410) 581-9008
- **Mailing address fax:** (410) 581-6720

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 14054 | MD | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 4876 | MD | Yes |

## Other

- **Enumeration date:** 05/06/2010
- **Last updated:** 05/31/2024