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NPI Code Detail

MEDICARE: AGA FAMILY DENTISTRY LLC

MEDICARE: AGA FAMILY DENTISTRY LLC
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 Dentistry9871MD

General Provider Information

NPI Number : 1720234115
Entity Type Code : Organization
Provider Name (Legal Business Name) : AGA FAMILY DENTISTRY LLC
Provider Business Mailing Address
First Line : 1008 INGLESIDE AVE
Second Line :
City : CATONSVILLE
State : MD
Zip : 21228-1317
Country : US
Telephone Number : 410-747-3163
Fax Number :
Provider Business Practice Location Address
First Line : 1008 INGLESIDE AVE
Second Line :
City : CATONSVILLE
State : MD
Zip : 21228-1317
Country : US
Telephone Number : 410-747-3163
Fax Number :
Authorized Official
Title or Position : DENTIST
Name : DR. AMPILI G ABRAHAM
Credential : D.D.S
Telephone Number : 410-747-3163
Provider Enumeration Date : 08/18/2008
Last Update Date : 08/18/2008

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Directions to “AGA FAMILY DENTISTRY LLC ” Practice Location

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