| Advanced Dental Care Of Baltimore | |
|
3407 Wilkens Ave Suite 205 Baltimore MD 21229-5072 | |
| (410) 525-0555 | |
| (410) 525-1055 |
| Full Name | Advanced Dental Care Of Baltimore |
|---|---|
| Speciality | Dentist |
| Location | 3407 Wilkens Ave, Baltimore, Maryland |
| Authorized Official Name and Position | Omoteniola Awofolu (OWNER) |
| Authorized Official Contact | 4105250555 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Dental Care Of Baltimore 3407 Wilkens Ave Suite 205 Baltimore MD 21229-5072 Ph: (410) 525-0555 | Advanced Dental Care Of Baltimore 3407 Wilkens Ave Suite 205 Baltimore MD 21229-5072 Ph: (410) 525-0555 |
| NPI Number | 1417379777 |
|---|---|
| Provider Enumeration Date | 01/06/2014 |
| Last Update Date | 01/06/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417379777 | NPI | - | NPPES |
| 051736400 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 14929 (Maryland) | Primary |
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