| Kids By The Bay Dental Llc | |
|
5010 Regency Place Ste 102 White Plains MD 20695 | |
| (240) 776-2203 | |
| Not Available |
| Full Name | Kids By The Bay Dental Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 5010 Regency Place Ste 102, White Plains, Maryland |
| Authorized Official Name and Position | Joseph Brannon (MEMBER) |
| Authorized Official Contact | 2407762203 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kids By The Bay Dental Llc 5010 Regency Place Ste 102 White Plains MD 20695 Ph: (240) 776-2203 | Kids By The Bay Dental Llc 5010 Regency Place Ste 102 White Plains MD 20695 Ph: (240) 776-2203 |
| NPI Number | 1962914507 |
|---|---|
| Provider Enumeration Date | 11/03/2017 |
| Last Update Date | 11/03/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962914507 | NPI | - | NPPES |
| ZX6939 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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