Healthcare Provider Details

I. General information

NPI: 1497969208
Provider Name (Legal Business Name): CHESAPEAKE BAY DENTAL PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

328 N PHILADELPHIA BLVD
ABERDEEN MD
21001-1910
US

IV. Provider business mailing address

328 N PHILADELPHIA BLVD
ABERDEEN MD
21001-1910
US

V. Phone/Fax

Practice location:
  • Phone: 410-273-5446
  • Fax:
Mailing address:
  • Phone: 410-273-5446
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: DR. SHAMEEM AARA BHAM
Title or Position: PRESIDENT
Credential: DDS
Phone: 410-273-5446