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General NPI Number Information
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NPI Number | 1528873445
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Entity Type | Organization
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Legal Business Name | SUNSHINE DENTAL.INC
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Dates
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Enumeration Date | 02/10/2025
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Last Update Date | 02/10/2025
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Provider Practice Location Address
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Address Line | 1777 REISTERSTOWN RD
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City | PIKESVILLE
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State | MD
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Zip | 21208-1380
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Country | US
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Telephone | 443-208-2177
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Fax |
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Provider Business Mailing Address
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Address Line | 120 PATAPSCO LAND WAY
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City | BROOKLYN
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State | MD
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Zip | 21225-2380
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Country | US
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Telephone | 443-208-2177
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | BAGRAT ABAZYAN
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Credential | DDS
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Telephone | 443-208-2177
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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 |
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License Number State |
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