# OMOTENIOLA AWOFOLU DDS. LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Advanced Dental Care of Baltimore
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417379777
- **Authorized official:** DR. OMOTENIOLA AWOFOLU DDS (OWNER)
- **Authorized official phone:** (410) 525-0555

## Contact information

- **Practice address:** 3407 WILKENS AVE, SUITE 205, BALTIMORE, MD 21229-5072
- **Practice address phone:** (410) 525-0555
- **Practice address fax:** (410) 525-1055
- **Mailing address:** 3407 WILKENS AVE, SUITE 205, BALTIMORE, MD 21229-5072
- **Mailing address phone:** (410) 525-0555
- **Mailing address fax:** (410) 525-1055

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 14929 | MD | Yes |

## Other

- **Enumeration date:** 01/06/2014
- **Last updated:** 01/06/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 051736400 | — | MD |