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Organization

COLUMBIA PRIME DENTAL, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LUDMILA HRISTOVA TCHAKAROVA DDS (DDS/OWNER)
(410) 381-8283
Entity
Organization

Contact information

Practice address
6801 DOUGLAS LEGUM DR STE C, ELKRIDGE, MD 21075-6273
(410) 381-8283
(413) 254-5304
Mailing address
9084 LAMBSKIN LN, COLUMBIA, MD 21045-2939
(410) 992-6793

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
14156
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
027642100
MD
Enumeration date
05/09/2011
Last updated
07/23/2024
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