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General NPI Number Information
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NPI Number | 1619033008
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Entity Type | Organization
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Legal Business Name | GREATER MARYLAND DENTAL PARTNERS-COLUMBIA
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Dates
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Enumeration Date | 12/29/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 10840 LITTLE PATUXENT PKWY STE 303
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City | COLUMBIA
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State | MD
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Zip | 21044-3142
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Country | US
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Telephone | 410-997-2400
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Fax |
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Provider Business Mailing Address
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Address Line | 10840 LITTLE PATUXENT PKWY STE 303
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City | COLUMBIA
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State | MD
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Zip | 21044-3142
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Country | US
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Telephone | 410-997-2400
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Fax |
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | MR. BOB HAUSLER
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Credential |
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Telephone | 410-997-2400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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