Organization
DENTISTRY FOR CHILDREN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNY PRICE (OFFICE MANAGER)
(410) 819-0726
Entity
Organization
Contact information
Practice address
508 CYNWOOD DR, STE. B, EASTON, MD 21601-3892
(410) 819-0726
Mailing address
508 CYNWOOD DR, STE. B, EASTON, MD 21601-3892
(410) 819-0726
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
10918
MD
1223P0221X
Pediatric Dentistry
14062
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
162484900
—
MD
Enumeration date
05/15/2017
Last updated
05/15/2017
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