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Organization

SMILE LOFT COLUMBIA LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
VAIBHAV RAI (MEMBER)
(610) 216-0339
Entity
Organization

Contact information

Practice address
10818 HICKORY RIDGE RD STE 117, COLUMBIA, MD 21044-3622
(410) 997-4111
Mailing address
2001 MARTINS GRANT CT, CROWNSVILLE, MD 21032-1932

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
046068200
MD
Enumeration date
02/12/2021
Last updated
02/12/2021
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