Organization
NIC JORGE DENTAL, LLC
Active
Other names
Elysian Dental Studio
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NICOLAS ANDREW JORGE DMD (DENTIST)
(516) 457-8005
Entity
Organization
Contact information
Practice address
3290 N RIDGE RD STE 180, ELLICOTT CITY, MD 21043-3656
(410) 480-9111
Mailing address
3290 N RIDGE RD STE 180, ELLICOTT CITY, MD 21043-3656
(410) 480-9111
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
06/19/2024
Last updated
06/19/2024
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