| La Plata Dental, Llc | |
|
105 Centennial St Suite C La Plata MD 20646-6943 | |
| (240) 349-2439 | |
| Not Available |
| Full Name | La Plata Dental, Llc |
|---|---|
| Speciality | Dentist |
| Location | 105 Centennial St, La Plata, Maryland |
| Authorized Official Name and Position | Andrew Betaharon (OWNER) |
| Authorized Official Contact | 2403492439 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| La Plata Dental, Llc 105 Centennial St Suite C La Plata MD 20646-6943 Ph: () - | La Plata Dental, Llc 105 Centennial St Suite C La Plata MD 20646-6943 Ph: (240) 349-2439 |
| NPI Number | 1104270073 |
|---|---|
| Provider Enumeration Date | 04/18/2016 |
| Last Update Date | 04/18/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104270073 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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