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General NPI Number Information
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NPI Number | 1316745714
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Entity Type | Organization
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Legal Business Name | TOOTHFULLY YOURS OF GLEN BURNIE, LLC
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Dates
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Enumeration Date | 03/04/2025
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Last Update Date | 03/04/2025
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Provider Practice Location Address
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Address Line | 7711 QUARTERFIELD RD STE C1
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City | GLEN BURNIE
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State | MD
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Zip | 21061-4591
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Country | US
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Telephone | 410-760-4445
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Fax | 410-630-0001
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Provider Business Mailing Address
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Address Line | 7711 QUARTERFIELD RD STE C1
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City | GLEN BURNIE
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State | MD
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Zip | 21061-4591
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Country | US
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Telephone | 410-760-4445
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Fax | 410-630-0001
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. POOJA SONI
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Credential | DDS
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Telephone | 240-899-7841
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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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