| Frederick Kidds Pediatric Dentistry Llc | |
|
211 Shorebird St Ste B Frederick MD 21701-1963 | |
| (301) 202-5041 | |
| Not Available |
| Full Name | Frederick Kidds Pediatric Dentistry Llc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 211 Shorebird St Ste B, Frederick, Maryland |
| Authorized Official Name and Position | D'audra Cole (DENTIST/OWNER) |
| Authorized Official Contact | 3012025041 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Frederick Kidds Pediatric Dentistry Llc 211 Shorebird St Ste B Frederick MD 21701-1963 Ph: (301) 202-5041 | Frederick Kidds Pediatric Dentistry Llc 211 Shorebird St Ste B Frederick MD 21701-1963 Ph: (301) 202-5041 |
| NPI Number | 1043694623 |
|---|---|
| Provider Enumeration Date | 07/14/2015 |
| Last Update Date | 07/14/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043694623 | NPI | - | NPPES |
| 1194880633 | Other | MD | INDIVIDUAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 14079 (Maryland) | Primary |
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