Organization
LIBERTY DENTAL CARE & DENTURES-LLC
Active
Other names
Liberty Dental Care & Dentures
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KHALID RASHID CHAUDRY DDS (DENTIST/OWNER)
(917) 815-6369
Entity
Organization
Contact information
Practice address
7100 SENNET PL, SUITE E, LIBERTY TOWNSHP, OH 45069-1794
(917) 815-6369
Mailing address
7100 SENNET PLACE, SUITE E, LIBERTY TOWNSHIP, OH 45069
(917) 815-6369
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
30-022036
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2525959
—
OH
01
—
310994808057
CARE SOURCE
OH
Enumeration date
10/20/2016
Last updated
10/20/2016
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