Individual
GEORGE JAMES KASSOLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
214 MOUNT CARMEL RD, PARKTON, MD 21120-9725
(410) 329-6300
(410) 329-6300
Mailing address
214 MOUNT CARMEL RD, PARKTON, MD 21120-9725
(410) 329-6300
(410) 329-6300
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5388
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3714
BLUE CROSS BLUE SHIELD
MD
Enumeration date
04/25/2007
Last updated
07/08/2007
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