Healthcare Provider Details

I. General information

NPI: 1518081892
Provider Name (Legal Business Name): DENTAL ONE ASSOCIATES EASTPOINT PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 N POINT BLVD
BALTIMORE MD
21224-3413
US

IV. Provider business mailing address

1001 N POINT BLVD
BALTIMORE MD
21224-3413
US

V. Phone/Fax

Practice location:
  • Phone: 410-288-3000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MIKE COLE
Title or Position: INSURANCE DIRECTOR
Credential:
Phone: 727-726-1611