Healthcare Provider Details

I. General information

NPI: 1568616993
Provider Name (Legal Business Name): NEEL S. SATPUTE, DDS, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/12/2008
Last Update Date: 11/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 QUARRY LAKE DR SUITE 190
BALTIMORE MD
21209-3742
US

IV. Provider business mailing address

2700 QUARRY LAKE DR SUITE 190
BALTIMORE MD
21209-3742
US

V. Phone/Fax

Practice location:
  • Phone: 410-484-4401
  • Fax:
Mailing address:
  • Phone: 410-484-4401
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number13957
License Number StateMD

VIII. Authorized Official

Name: DR. NEEL SATISH SATPUTE
Title or Position: PRESIDENT
Credential: D.D.S.
Phone: 410-484-4401