| Severn Pediatric Dentistry | |
|
2288 Blue Water Blvd Ste 328 Odenton MD 21113-3309 | |
| (410) 995-8000 | |
| Not Available |
| Full Name | Severn Pediatric Dentistry |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 2288 Blue Water Blvd Ste 328, Odenton, Maryland |
| Authorized Official Name and Position | Soe T Mon (CO-OWNER) |
| Authorized Official Contact | 4109958000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Severn Pediatric Dentistry 2288 Blue Water Blvd Ste 328 Odenton MD 21113-3309 Ph: (410) 995-8000 | Severn Pediatric Dentistry 2288 Blue Water Blvd Ste 328 Odenton MD 21113-3309 Ph: (410) 995-8000 |
| NPI Number | 1376065193 |
|---|---|
| Provider Enumeration Date | 07/13/2017 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376065193 | NPI | - | NPPES |
| 59291 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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