Gloria Kidz Dental Llc | |
7951 Crain Hwy S Glen Burnie MD 21061-4934 | |
(410) 969-9090 | |
(410) 969-9055 |
Full Name | Gloria Kidz Dental Llc |
---|---|
Speciality | Dentist - Pediatric Dentistry |
Location | 7951 Crain Hwy S, Glen Burnie, Maryland |
Authorized Official Name and Position | Hae Wan Kim (MEMBER) |
Authorized Official Contact | 4109699090 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Gloria Kidz Dental Llc 7951 Crain Hwy S Glen Burnie MD 21061-4934 Ph: (410) 969-9090 | Gloria Kidz Dental Llc 7951 Crain Hwy S Glen Burnie MD 21061-4934 Ph: (410) 969-9090 |
NPI Number | 1568775880 |
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Provider Enumeration Date | 07/15/2010 |
Last Update Date | 11/14/2014 |
Identifier | Type | State | Issuer |
---|---|---|---|
1568775880 | NPI | - | NPPES |
024168700 | Medicaid | MD |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223P0221X | Dentist - Pediatric Dentistry | 14267 (Maryland) | Primary |
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