Healthcare Provider Details

I. General information

NPI: 1396909073
Provider Name (Legal Business Name): BEL AIR DENTAL CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2008
Last Update Date: 07/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 BEL AIR RD
FALLSTON MD
21047-2749
US

IV. Provider business mailing address

2300 BEL AIR RD
FALLSTON MD
21047-2749
US

V. Phone/Fax

Practice location:
  • Phone: 410-879-8424
  • Fax: 410-877-9654
Mailing address:
  • Phone: 410-879-8424
  • Fax: 410-877-9654

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number6653
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number13687
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number7820
License Number StateMD

VIII. Authorized Official

Name: ALAN ROBERT SCHARF
Title or Position: PARTNER
Credential: DDS
Phone: 410-879-8424