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General NPI Number Information
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NPI Number | 1801788948
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Entity Type | Organization
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Legal Business Name | HODIAH DENTAL LLC
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Dates
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Enumeration Date | 07/15/2025
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Last Update Date | 07/15/2025
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Provider Practice Location Address
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Address Line | 6100 DAYLONG LN STE 101
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City | CLARKSVILLE
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State | MD
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Zip | 21029-1631
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Country | US
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Telephone | 667-200-5912
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Fax | 443-546-3330
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Provider Business Mailing Address
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Address Line | 6100 DAYLONG LN STE 101
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City | CLARKSVILLE
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State | MD
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Zip | 21029-1631
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Country | US
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Telephone | 667-200-5912
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Fax | 443-546-3330
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Authorized Official
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Title or Position | DENTIST
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Name | HYOUNG KEUN KIM
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Credential | DMD
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Telephone | 240-535-1885
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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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