| Blue Water Dental Care | |
|
2288 Blue Water Blvd Suite 420 Odenton MD 21113 | |
| (410) 674-3000 | |
| (410) 674-7000 |
| Full Name | Blue Water Dental Care |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2288 Blue Water Blvd, Odenton, Maryland |
| Authorized Official Name and Position | Glenn Michael Poch (MANAGING MEMBER) |
| Authorized Official Contact | 4106743000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blue Water Dental Care 2288 Blue Water Blvd Suite 420 Odenton MD 21113 Ph: (410) 674-3000 | Blue Water Dental Care 2288 Blue Water Blvd Suite 420 Odenton MD 21113 Ph: (410) 674-3000 |
| NPI Number | 1609978881 |
|---|---|
| Provider Enumeration Date | 09/01/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609978881 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 12795 (Maryland) | Primary |
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