Organization
CHESAPEAKE PEDIATRIC DENTAL GROUP INC
Active
Parent organization
CHESAPEAKE PEDIATRIC DENTAL GROUP, INC
Other names
Chesapeake Pediatric Dental Group, LLC, CPDG-PH, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
CHESAPEAKE PEDIATRIC DENTAL GROUP, INC
Authorized official
DR. HAKAN KOYMEN DDS, MS (PRESIDENT)
(410) 248-3384
Entity
Organization
Contact information
Practice address
5002 HONEYGO CENTER DR STE 101, PERRY HALL, MD 21128-8962
(410) 248-3384
(410) 248-3385
Mailing address
5002 HONEYGO CENTER DR STE 101, PERRY HALL, MD 21128-8962
(410) 248-3384
(410) 248-3385
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
12770
MD
1223P0221X
Pediatric Dentistry
13889
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008494860
—
MD
05
—
022999700
—
MD
05
—
026120300
—
MD
05
—
036344800
—
MD
05
—
9200608
—
MD
Enumeration date
07/13/2009
Last updated
12/06/2023
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