Organization
MARYLAND LIP AND TONGUE TIE CENTER LLC
Active
Other names
Maryland Lip & Tongue Tie Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SU KIM DDS (PRESIDENT)
(443) 539-7979
Entity
Organization
Contact information
Practice address
8808 CENTRE PARK DR STE 307, COLUMBIA, MD 21045-2126
(443) 539-7979
(443) 832-6110
Mailing address
8808 CENTRE PARK DR STE 307, COLUMBIA, MD 21045-2126
(443) 539-7979
(443) 832-6110
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
10/17/2022
Last updated
10/17/2022
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