| Pikesville Dental Associates | |
|
3635 Old Court Rd Ste 510 Baltimore MD 21208-3916 | |
| (443) 540-6007 | |
| (443) 609-4713 |
| Full Name | Pikesville Dental Associates |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 3635 Old Court Rd Ste 510, Baltimore, Maryland |
| Authorized Official Name and Position | Sumanya Venkat Rao (GENERAL DENTIST) |
| Authorized Official Contact | 4438986788 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pikesville Dental Associates 3635 Old Court Rd Ste 510 Pikesville MD 21208-3916 Ph: (443) 898-6788 | Pikesville Dental Associates 3635 Old Court Rd Ste 510 Baltimore MD 21208-3916 Ph: (443) 540-6007 |
| NPI Number | 1255819470 |
|---|---|
| Provider Enumeration Date | 07/31/2018 |
| Last Update Date | 01/27/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255819470 | NPI | - | NPPES |
| 089290400 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 15681 (Maryland) | Primary |
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