| Rock Kids Dental | |
|
1631 Crofton Ctr Crofton MD 21114-1343 | |
| (410) 774-0221 | |
| (410) 774-0251 |
| Full Name | Rock Kids Dental |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 1631 Crofton Ctr, Crofton, Maryland |
| Authorized Official Name and Position | Irene Ebunoluwa Apata (PEDIATRIC DENTIST/OWNER) |
| Authorized Official Contact | 4107740221 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rock Kids Dental 1631 Crofton Ctr Crofton MD 21114-1343 Ph: (410) 774-0221 | Rock Kids Dental 1631 Crofton Ctr Crofton MD 21114-1343 Ph: (410) 774-0221 |
| NPI Number | 1164136149 |
|---|---|
| Provider Enumeration Date | 01/13/2023 |
| Last Update Date | 09/11/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164136149 | NPI | - | NPPES |
| 1831452648 | Medicaid | MD | |
| D76904 | Other | MD | CDS |
| 056005700 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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