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NPI Code Detail

MEDICARE: DENTAL ASSOCIATES L.L.C.

MEDICARE: DENTAL ASSOCIATES L.L.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry

General Provider Information

NPI Number : 1205805801
Entity Type Code : Organization
Provider Name (Legal Business Name) : DENTAL ASSOCIATES L.L.C.
Provider Business Mailing Address
First Line : 603 NURSERY RD
Second Line :
City : WESTMINSTER
State : MD
Zip : 21157-6109
Country : US
Telephone Number : 410-876-6612
Fax Number : 410-876-3760
Provider Business Practice Location Address
First Line : 603 NURSERY RD
Second Line :
City : WESTMINSTER
State : MD
Zip : 21157-6109
Country : US
Telephone Number : 410-876-6612
Fax Number : 410-876-3760
Authorized Official
Title or Position : OWNER
Name : DR. MARSHALL W. FESCHE
Credential : D.D.S.
Telephone Number : 410-876-6612
Provider Enumeration Date : 03/16/2006
Last Update Date : 08/22/2020

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