Organization
COLLIVER DENTAL GROUP, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KATHERINE CHRISTINE COLLIVER (BUSINESS MANAGER)
(301) 662-5914
Entity
Organization
Contact information
Practice address
2090 OLD FARM DR, STE. B, FREDERICK, MD 21702-5400
(301) 662-5914
(301) 662-7340
Mailing address
2090 OLD FARM DR, STE. B, FREDERICK, MD 21702-5400
(301) 662-5914
(301) 662-7340
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
9614
MD
Other
Enumeration date
01/22/2007
Last updated
08/22/2020
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