Organization
KIDS BY THE BAY DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH BRANNON JR. DDS (MEMBER)
(240) 776-2203
Entity
Organization
Contact information
Practice address
5010 REGENCY PLACE STE 102, WHITE PLAINS, MD 20695
(240) 776-2203
Mailing address
5010 REGENCY PLACE STE 102, WHITE PLAINS, MD 20695
(240) 776-2203
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZX6939
—
SC
Enumeration date
11/03/2017
Last updated
11/03/2017
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