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General NPI Number Information
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NPI Number | 1629922190
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Entity Type | Organization
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Legal Business Name | COLUMBIA ENDODONTICS LLC
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Dates
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Enumeration Date | 02/23/2026
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Last Update Date | 02/23/2026
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Provider Practice Location Address
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Address Line | 10632 LITTLE PATUXENT PKWY STE 252
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City | COLUMBIA
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State | MD
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Zip | 21044-6237
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Country | US
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Telephone | 410-730-0755
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Fax | 410-730-3342
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Provider Business Mailing Address
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Address Line | 10632 LITTLE PATUXENT PKWY STE 252
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City | COLUMBIA
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State | MD
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Zip | 21044-6237
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Country | US
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Telephone | 410-730-0755
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Fax | 410-730-3342
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Authorized Official
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Title or Position | ENDODONTICS
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Name | DR. DAVID DESTA
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Credential | DDS,M.S.
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Telephone | 410-730-0755
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number |
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License Number State |
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