Organization
HIGHLANDTOWN DENTAL GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VLADIMIR SEMEREY (MANAGER)
(410) 685-0002
Entity
Organization
Contact information
Practice address
3715 EASTERN AVE, BALTIMORE, MD 21224-4208
(410) 327-5488
Mailing address
3715 EASTERN AVE, BALTIMORE, MD 21224-4208
(410) 327-5488
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
111047100
—
MD
Enumeration date
09/25/2020
Last updated
09/25/2020
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