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General NPI Number Information
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NPI Number | 1093576027
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Entity Type | Organization
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Legal Business Name | EASTERN SHORE PEDIATRIC DENTISTRY, LLC
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Dates
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Enumeration Date | 01/17/2024
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Last Update Date | 01/17/2024
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Provider Practice Location Address
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Address Line | 917 SNOW HILL RD STE D
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City | SALISBURY
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State | MD
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Zip | 21804-2408
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Country | US
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Telephone | 410-202-8515
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Fax |
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Provider Business Mailing Address
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Address Line | 917 SNOW HILL RD STE D
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City | SALISBURY
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State | MD
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Zip | 21804-2408
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Country | US
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Telephone | 410-202-8515
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MATTHEW ASERMELY
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Credential | DDS
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Telephone | 410-202-8515
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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