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General NPI Number Information
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NPI Number | 1598687741
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Entity Type | Organization
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Legal Business Name | HAGERSTOWN PRIME DENTAL
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Dates
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Enumeration Date | 07/29/2026
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Last Update Date | 07/29/2026
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Provider Practice Location Address
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Address Line | 1825 HOWELL RD STE 1
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City | HAGERSTOWN
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State | MD
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Zip | 21740-6619
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Country | US
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Telephone | 301-766-7000
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Fax | 301-323-8639
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Provider Business Mailing Address
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Address Line | 1825 HOWELL RD STE 1
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City | HAGERSTOWN
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State | MD
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Zip | 21740-6619
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Country | US
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Telephone | 301-766-7000
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Fax | 301-323-8639
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Authorized Official
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Title or Position | CEO
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Name | HEUNG JOO SUNG
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Credential |
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Telephone | 301-766-7000
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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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