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General NPI Number Information
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NPI Number | 1134798770
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Entity Type | Organization
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Legal Business Name | GOOD DAY FAMILY DENTAL, LLC
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Dates
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Enumeration Date | 06/18/2021
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Last Update Date | 06/18/2021
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Provider Practice Location Address
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Address Line | 10818 HICKORY RIDGE RD
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City | COLUMBIA
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State | MD
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Zip | 21044-3622
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Country | US
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Telephone | 781-883-2081
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Fax |
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Provider Business Mailing Address
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Address Line | 10633 WARBURTON CT
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City | ELLICOTT CITY
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State | MD
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Zip | 21042-1461
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | CHAERYUN YI
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Credential |
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Telephone | 781-883-2081
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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