| Spark Dental Llc | |
|
18077 Garland Groh Blvd Hagerstown MD 21740-2064 | |
| (301) 888-8555 | |
| Not Available |
| Full Name | Spark Dental Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 18077 Garland Groh Blvd, Hagerstown, Maryland |
| Authorized Official Name and Position | Madhu Venkata Rama Raju Nadimpalli (GENERAL DENTIST/ OWNER) |
| Authorized Official Contact | 2012577095 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Spark Dental Llc 12233 Hayland Farm Way Ellicott City MD 21042-6027 Ph: (201) 257-7095 | Spark Dental Llc 18077 Garland Groh Blvd Hagerstown MD 21740-2064 Ph: (301) 888-8555 |
| NPI Number | 1760221386 |
|---|---|
| Provider Enumeration Date | 05/22/2024 |
| Last Update Date | 05/22/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760221386 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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