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General NPI Number Information
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NPI Number | 1942202692
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Entity Type | Organization
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Legal Business Name | KERNAN DENTISTRY
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Dates
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Enumeration Date | 08/12/2005
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Last Update Date | 06/27/2023
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Provider Practice Location Address
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Address Line | 2200 KERNAN DR DENTAL SUITE T500
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City | BALTIMORE
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State | MD
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Zip | 21207-6665
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Country | US
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Telephone | 410-448-6290
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Fax | 410-448-6883
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Provider Business Mailing Address
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Address Line | PO BOX 62015
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City | BALTIMORE
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State | MD
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Zip | 21264-2015
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | MARINA BOGIN
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Credential |
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Telephone | 410-448-6289
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State | MD
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