Organization
CHILDREN'S DENTISTRY AT ODENTON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARIA SEVILLA GUEVARA DMD (PRESIDENT)
(410) 672-1100
Entity
Organization
Contact information
Practice address
1215 ANNAPOLIS RD, SUITE 106, ODENTON, MD 21113-1344
(410) 672-1100
(410) 672-1107
Mailing address
1215 ANNAPOLIS RD, SUITE 106, ODENTON, MD 21113-1344
(410) 672-1100
(410) 672-1107
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
12374
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
135705100
—
MD
Enumeration date
11/14/2011
Last updated
11/14/2011
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