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NPI 1346646379

NPI 1346646379 : HALETHORPE ORTHODONTICS, LLC : BALTIMORE, MD

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General NPI Number Information
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    NPI Number           |    1346646379
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    Entity Type          |    Organization 
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    Legal Business Name  |    HALETHORPE ORTHODONTICS, LLC 
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Dates
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    Enumeration Date     |    11/19/2014
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    Last Update Date     |    11/19/2014
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Provider Practice Location Address
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    Address Line         |    4367 HOLLINS FERRY RD SUITE 1D
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    City                 |    BALTIMORE
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    State                |    MD
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    Zip                  |    21227-3400
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    Country              |    US
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    Telephone            |    410-565-6282
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    Fax                  |    301-384-9877
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Provider Business Mailing Address
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    Address Line         |    4367 HOLLINS FERRY RD SUITE 1D
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    City                 |    BALTIMORE
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    State                |    MD
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    Zip                  |    21227-3400
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    Country              |    US
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    Telephone            |    410-565-6282
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    Fax                  |    301-384-9877
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |    DR. RAVI  KAUR 
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    Credential           |    DDS
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    Telephone            |    410-565-6282
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    1223X0400X
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    Taxonomy Name        |    Orthodontics and Dentofacial Orthopedics Dentistry
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    License Number       |    
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    License Number State |    MD
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