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Organization
CHURCHTON DENTAL CARE
Active
Organization
CHURCHTON DENTAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GRAHAM DERSLEY D.D.S. (OWNER)
(443) 294-2025
Entity
Organization
Contact information
Practice address
5570 SHADY SIDE RD, UNIT A, CHURCHTON, MD 20733-9639
(443) 294-2025
Mailing address
5570 SHADY SIDE RD, UNIT A, CHURCHTON, MD 20733-9639
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
—
—
Other
Enumeration date
11/09/2012
Last updated
11/09/2012
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