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General NPI Number Information
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NPI Number | 1467314989
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Entity Type | Organization
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Legal Business Name | ANCHOR PERIODONTICS LLC
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Dates
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Enumeration Date | 12/02/2025
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Last Update Date | 12/02/2025
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Provider Practice Location Address
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Address Line | 214 PIER 1 RD STE 140
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City | STEVENSVILLE
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State | MD
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Zip | 21666-2863
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Country | US
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Telephone | 410-604-9555
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Fax |
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Provider Business Mailing Address
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Address Line | 214 PIER 1 RD STE 140
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City | STEVENSVILLE
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State | MD
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Zip | 21666-2863
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Country | US
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Telephone | 410-604-9555
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Fax |
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Authorized Official
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Title or Position | OWNER/DMD
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Name | DR. ELIZABETH POLAK
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Credential | DMD
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Telephone | 410-604-9555
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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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