Organization
MOUNT AIRY DENTAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OLUMIDE BOLARINWA DMD MSC (OWNER)
(301) 829-2220
Entity
Organization
Contact information
Practice address
1517 RIDGESIDE DR, MOUNT AIRY, MD 21771-5285
(301) 829-2220
Mailing address
1517 RIDGESIDE DR, MOUNT AIRY, MD 21771-5285
(301) 829-2220
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1164545794
DENTIST
MD
01
—
1265982482
DENTIST
MD
Enumeration date
12/21/2020
Last updated
12/21/2020
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