Organization
LA PLATA DENTAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW BETAHARON DDS (OWNER)
(240) 349-2439
Entity
Organization
Contact information
Practice address
105 CENTENNIAL ST, SUITE C, LA PLATA, MD 20646-6943
(240) 349-2439
Mailing address
105 CENTENNIAL ST, SUITE C, LA PLATA, MD 20646-6943
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
04/18/2016
Last updated
04/18/2016
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