| Smile Loft Columbia Llc | |
|
10818 Hickory Ridge Rd Ste 117 Columbia MD 21044-3622 | |
| (410) 997-4111 | |
| Not Available |
| Full Name | Smile Loft Columbia Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 10818 Hickory Ridge Rd Ste 117, Columbia, Maryland |
| Authorized Official Name and Position | Vaibhav Rai (MEMBER) |
| Authorized Official Contact | 6102160339 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Smile Loft Columbia Llc 2001 Martins Grant Ct Crownsville MD 21032-1932 Ph: () - | Smile Loft Columbia Llc 10818 Hickory Ridge Rd Ste 117 Columbia MD 21044-3622 Ph: (410) 997-4111 |
| NPI Number | 1134712961 |
|---|---|
| Provider Enumeration Date | 02/12/2021 |
| Last Update Date | 02/12/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134712961 | NPI | - | NPPES |
| 046068200 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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