| Smile Loft Glen Burnie Llc | |
|
325 Hospital Dr Ste 101 Glen Burnie MD 21061-5806 | |
| (410) 768-4488 | |
| Not Available |
| Full Name | Smile Loft Glen Burnie Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 325 Hospital Dr Ste 101, Glen Burnie, Maryland |
| Authorized Official Name and Position | Christine Rai (DIRECTOR OF HR) |
| Authorized Official Contact | 4106103071 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Smile Loft Glen Burnie Llc 325 Hospital Dr Ste 101 Glen Burnie MD 21061-5806 Ph: (410) 768-4488 | Smile Loft Glen Burnie Llc 325 Hospital Dr Ste 101 Glen Burnie MD 21061-5806 Ph: (410) 768-4488 |
| NPI Number | 1568072825 |
|---|---|
| Provider Enumeration Date | 08/03/2020 |
| Last Update Date | 08/03/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568072825 | NPI | - | NPPES |
| 046068200 | Medicaid | MD | |
| 057073700 | Medicaid | DE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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