Providence Dental Specialists | |
1731 Theale Way Hanover MD 21076-1899 | |
(443) 858-8377 | |
Not Available |
Full Name | Providence Dental Specialists |
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Speciality | Clinic/center - Dental |
Location | 1731 Theale Way, Hanover, Maryland |
Authorized Official Name and Position | Eileen Buckle (DENTIST) |
Authorized Official Contact | 4438588377 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Providence Dental Specialists 1731 Theale Way Hanover MD 21076-1899 Ph: (443) 858-8377 | Providence Dental Specialists 1731 Theale Way Hanover MD 21076-1899 Ph: (443) 858-8377 |
NPI Number | 1205297546 |
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Provider Enumeration Date | 03/15/2016 |
Last Update Date | 03/15/2016 |
Identifier | Type | State | Issuer |
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1205297546 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QD0000X | Clinic/center - Dental | 16121 (Maryland) | Primary |
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