Organization
LOGOS DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID KIM DDS (PRESIDENT)
(443) 350-9221
Entity
Organization
Contact information
Practice address
130 E PULASKI HWY, ELKTON, MD 21921-6430
(443) 350-9221
Mailing address
130 E PULASKI HWY, ELKTON, MD 21921-6430
(443) 350-9221
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
10839
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
081934400
—
MD
Enumeration date
12/03/2010
Last updated
12/03/2010
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