Organization
SHORE FAMILY DENTISTRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IJEOMA TAGBO DMD (MEMBER)
(410) 725-8373
Entity
Organization
Contact information
Practice address
8850 COLUMBIA 100 PKWY STE 310, COLUMBIA, MD 21045-2377
(443) 385-0285
(443) 385-0286
Mailing address
11101 RESORT RD # 190, ELLICOTT CITY, MD 21042-2086
(410) 725-8373
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
04/30/2025
Last updated
04/30/2025
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