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NPI Code Detail

MEDICARE: DENTAL GROUP OF BALTIMORE CITY

MEDICARE: DENTAL GROUP OF BALTIMORE CITY
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 : 1508551318
Entity Type Code : Organization
Provider Name (Legal Business Name) : DENTAL GROUP OF BALTIMORE CITY
Provider Business Mailing Address
First Line : 300 N CHARLES ST STE D
Second Line :
City : BALTIMORE
State : MD
Zip : 21201-4305
Country : US
Telephone Number : 410-685-0002
Fax Number :
Provider Business Practice Location Address
First Line : 300 N CHARLES ST STE D
Second Line :
City : BALTIMORE
State : MD
Zip : 21201-4305
Country : US
Telephone Number : 410-685-0002
Fax Number :
Authorized Official
Title or Position : MANAGER
Name : VLADIMIR SEMEREY
Credential :
Telephone Number : 443-980-8263
Provider Enumeration Date : 04/07/2023
Last Update Date : 04/07/2023

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Directions to “DENTAL GROUP OF BALTIMORE CITY ” Practice Location

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