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General NPI Number Information
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NPI Number | 1245441625
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Entity Type | Organization
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Legal Business Name | BEL AIR DENTAL ASSOCIATES
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Dates
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Enumeration Date | 05/25/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 10 W. BROADWAY LOWER LEVEL
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City | BEL AIR
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State | MD
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Zip | 21014
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Country | US
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Telephone | 410-879-8189
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Fax | 410-879-6121
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Provider Business Mailing Address
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Address Line | 10 W. BROADWAY LOWER LEVEL
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City | BEL AIR
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State | MD
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Zip | 21014
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Country | US
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Telephone | 410-879-8189
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Fax | 410-879-6121
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Authorized Official
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Title or Position | DENTIST
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Name | DR. STAVROS PAPAERACLEOUS
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Credential | DDS
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Telephone | 410-879-8189
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 8530
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License Number State | MD
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