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Organization

PARAGON DENTAL, LLC

Active
Other names
College Park Dental Associates
Organization subpart
No

Provider details

NPI number
Authorized official
YULIYA KUPCHENKO (MANAGER)
(301) 474-8900
Entity
Organization

Contact information

Practice address
9009 RHODE ISLAND AVE, COLLEGE PARK, MD 20740-1929
(301) 474-8900
Mailing address
9009 RHODE ISLAND AVE, COLLEGE PARK, MD 20740-1929

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
111733500
MD
Enumeration date
01/09/2019
Last updated
01/11/2019
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