| Centennial Dental | |
|
10318a Baltimore National Pike Ellicott City MD 21042-2128 | |
| (410) 480-2710 | |
| Not Available |
| Full Name | Centennial Dental |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 10318a Baltimore National Pike, Ellicott City, Maryland |
| Authorized Official Name and Position | Petro Tymiuk (DENTIST) |
| Authorized Official Contact | 4104802710 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Centennial Dental 10318a Baltimore National Pike Ellicott City MD 21042-2128 Ph: (410) 480-2710 | Centennial Dental 10318a Baltimore National Pike Ellicott City MD 21042-2128 Ph: (410) 480-2710 |
| NPI Number | 1376319202 |
|---|---|
| Provider Enumeration Date | 12/01/2023 |
| Last Update Date | 12/01/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376319202 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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