Organization
EASTERN AVENUE DENTAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SINHA KANG (DENTIST)
(410) 335-7771
Entity
Organization
Contact information
Practice address
12412 EASTERN AVE, BALTIMORE, MD 21220
(410) 335-7771
Mailing address
PO BOX B, CHASE, MD 21027-0020
(410) 335-7771
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
12853
MD
122300000X
Dentist
Primary
13144
MD
122300000X
Dentist
14921
MD
122300000X
Dentist
15012
MD
Other
Enumeration date
09/05/2014
Last updated
09/09/2014
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