| Glade Dental Practice Llc | |
|
11710 Reisterstown Rd 201 Reisterstown MD 21136-3363 | |
| (410) 833-8380 | |
| Not Available |
| Full Name | Glade Dental Practice Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 11710 Reisterstown Rd, Reisterstown, Maryland |
| Authorized Official Name and Position | Ketan Ginoya (MANAGER) |
| Authorized Official Contact | 4108338380 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Glade Dental Practice Llc 11710 Reisterstown Rd 201 Reisterstown MD 21136-3363 Ph: (410) 833-8380 | Glade Dental Practice Llc 11710 Reisterstown Rd 201 Reisterstown MD 21136-3363 Ph: (410) 833-8380 |
| NPI Number | 1922463488 |
|---|---|
| Provider Enumeration Date | 12/28/2015 |
| Last Update Date | 12/28/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922463488 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 16179 (Maryland) | Primary |
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