| Woodstock Family Dental Llc | |
|
10741 Birmingham Way Woodstock MD 21163-1403 | |
| (410) 750-7855 | |
| Not Available |
| Full Name | Woodstock Family Dental Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 10741 Birmingham Way, Woodstock, Maryland |
| Authorized Official Name and Position | Michael Listhaus (PRESIDENT) |
| Authorized Official Contact | 7187106412 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Woodstock Family Dental Llc 10741 Birmingham Way Woodstock MD 21163-1403 Ph: (410) 750-7855 | Woodstock Family Dental Llc 10741 Birmingham Way Woodstock MD 21163-1403 Ph: (410) 750-7855 |
| NPI Number | 1780411272 |
|---|---|
| Provider Enumeration Date | 09/18/2024 |
| Last Update Date | 09/18/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780411272 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
Walter M. Mazzella, D.d.s., P.c. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 10775 Birmingham Way, Suite 1, Woodstock, MD 21163 Phone: 410-203-2552 Fax: 410-203-2546 |