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Organization
PARAGON DENTAL, LLC
Active
Organization
PARAGON DENTAL, LLC
Active
Other names
College Park Dental Associates
Organization subpart
No
Provider details
NPI number
Authorized official
YULIYA KUPCHENKO (MANAGER)
(301) 474-8900
Entity
Organization
Contact information
Practice address
9009 RHODE ISLAND AVE, COLLEGE PARK, MD 20740-1929
(301) 474-8900
Mailing address
9009 RHODE ISLAND AVE, COLLEGE PARK, MD 20740-1929
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
111733500
—
MD
Enumeration date
01/09/2019
Last updated
01/11/2019
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