Organization
OMOTENIOLA AWOFOLU DDS. LLC
Active
Other names
Advanced Dental Care of Baltimore
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OMOTENIOLA AWOFOLU DDS (OWNER)
(410) 525-0555
Entity
Organization
Contact information
Practice address
3407 WILKENS AVE, SUITE 205, BALTIMORE, MD 21229-5072
(410) 525-0555
(410) 525-1055
Mailing address
3407 WILKENS AVE, SUITE 205, BALTIMORE, MD 21229-5072
(410) 525-0555
(410) 525-1055
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
14929
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
051736400
—
MD
Enumeration date
01/06/2014
Last updated
01/06/2014
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