Organization
PG PLAZE DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROSTISLAV KRASNOV DDS (OWNER)
(301) 933-9300
Entity
Organization
Contact information
Practice address
3500 E WEST HWY, THE MALL AT PRINCE GEORGE, HYATTSVILLE, MD 20782-1916
(301) 933-9300
Mailing address
3500 E WEST HWY, THE MALL AT PRINCE GEORGE, HYATTSVILLE, MD 20782-1916
(301) 933-9300
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
06/24/2014
Last updated
06/24/2014
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