| Petra Dentistry Llc | |
|
10910 Little Patuxent Pkwy Suite 206 Columbia MD 21044-3078 | |
| (410) 740-8588 | |
| (410) 740-9755 |
| Full Name | Petra Dentistry Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 10910 Little Patuxent Pkwy, Columbia, Maryland |
| Authorized Official Name and Position | Lara E Philippi (DENTIST/OWNER) |
| Authorized Official Contact | 4107408588 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Petra Dentistry Llc 10910 Little Patuxent Pkwy Suite 206 Columbia MD 21044-3078 Ph: (410) 740-8588 | Petra Dentistry Llc 10910 Little Patuxent Pkwy Suite 206 Columbia MD 21044-3078 Ph: (410) 740-8588 |
| NPI Number | 1598850422 |
|---|---|
| Provider Enumeration Date | 10/04/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598850422 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 12458 (Maryland) | Primary |
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