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Organization
KIDS BY THE BAY DENTAL LLC
Active
Organization
KIDS BY THE BAY DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH BRANNON JR. DDS (MEMBER)
(240) 776-2203
Entity
Organization
Contact information
Practice address
5010 REGENCY PLACE STE 102, WHITE PLAINS, MD 20695
(240) 776-2203
Mailing address
5010 REGENCY PLACE STE 102, WHITE PLAINS, MD 20695
(240) 776-2203
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZX6939
—
SC
Enumeration date
11/03/2017
Last updated
11/03/2017
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