Organization
MD-SG DENTAL, LLC
Active
Other names
Aspen Dental
Organization subpart
No
Provider details
NPI number
Authorized official
SHEKHAR GUPTA DDS (OWNER DENTIST)
(301) 800-7041
Entity
Organization
Contact information
Practice address
1730 MASSEY BLVD STE 106, HAGERSTOWN, MD 21740-6973
(866) 273-8204
Mailing address
PO BOX 3189, SYRACUSE, NY 13220-3189
(866) 273-8204
(866) 803-4943
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
15311
MD
Other
Enumeration date
07/17/2013
Last updated
04/15/2014
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