Organization
STELLAR DENTAL HYATTSVILLE, LLC
Active
Parent organization
STELLAR DENTAL
Organization subpart
Yes
Provider details
NPI number
Legal business name
STELLAR DENTAL
Authorized official
DR. ALLEN GOTORA DDS (DEO)
(301) 853-1567
Entity
Organization
Contact information
Practice address
5813 EASTERN AVE, HYATTSVILLE, MD 20782-2201
(301) 853-1567
Mailing address
5813 EASTERN AVE, HYATTSVILLE, MD 20782-2201
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
14124
MD
1223G0001X
General Practice Dentistry
14892
MD
Other
Enumeration date
08/01/2012
Last updated
08/01/2012
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