| Belvedere Square Dental Llc | |
|
14 Ruby Field Ct Baltimore MD 21209-1559 | |
| (201) 417-5119 | |
| Not Available |
| Full Name | Belvedere Square Dental Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 14 Ruby Field Ct, Baltimore, Maryland |
| Authorized Official Name and Position | Helene Shapiro (DENTIST) |
| Authorized Official Contact | 2014175119 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Belvedere Square Dental Llc 14 Ruby Field Ct Baltimore MD 21209-1559 Ph: (201) 417-5119 | Belvedere Square Dental Llc 14 Ruby Field Ct Baltimore MD 21209-1559 Ph: (201) 417-5119 |
| NPI Number | 1104271279 |
|---|---|
| Provider Enumeration Date | 04/26/2016 |
| Last Update Date | 04/26/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104271279 | NPI | - | NPPES |
| 037849600 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 14458 (Maryland) | Primary |
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