| Kernan Dentistry | |
|
2200 Kernan Dr Dental Suite T500 Baltimore MD 21207-6665 | |
| (410) 448-6290 | |
| (410) 448-6883 |
| Full Name | Kernan Dentistry |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 2200 Kernan Dr, Baltimore, Maryland |
| Authorized Official Name and Position | Marina Bogin (CFO) |
| Authorized Official Contact | 4104486289 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kernan Dentistry Po Box 62015 Baltimore MD 21264-2015 Ph: () - | Kernan Dentistry 2200 Kernan Dr Dental Suite T500 Baltimore MD 21207-6665 Ph: (410) 448-6290 |
| NPI Number | 1942202692 |
|---|---|
| Provider Enumeration Date | 08/12/2005 |
| Last Update Date | 06/27/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942202692 | NPI | - | NPPES |
| 9282-1 | Other | MD | UNITED HEALTHCARE ID |
| S165 | Other | MD | DENTAL NETWORK ID |
| 105664 | Other | MD | DORAL DENTAL LOCATION ID |
| 164252 | Other | MD | DORAL DENTAL PAYOR ID |
| 800194400 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (Maryland) | Primary |
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