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Organization
BURWOOD VILLAGE DENTISTRY LLC
Active
Organization
BURWOOD VILLAGE DENTISTRY LLC
Active
Other names
Burwood Village Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
ISHTIAQ ROUF (MANAGER)
(617) 817-0681
Entity
Organization
Contact information
Practice address
1608 W FURNACE BRANCH RD STE A, GLEN BURNIE, MD 21061-1411
(410) 859-1038
Mailing address
1608 W FURNACE BRANCH RD STE A, GLEN BURNIE, MD 21061-1411
(410) 859-1038
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
01/24/2024
Last updated
01/24/2024
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