| Marla Kush Prokop, Dmd, Pa | |
|
621 Ridgely Ave Suite 202 Annapolis MD 21401-1081 | |
| (410) 897-1931 | |
| (410) 897-1932 |
| Full Name | Marla Kush Prokop, Dmd, Pa |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 621 Ridgely Ave, Annapolis, Maryland |
| Authorized Official Name and Position | Marla Kush Prokop (PEDIATRIC DENTIST) |
| Authorized Official Contact | 4108971931 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Marla Kush Prokop, Dmd, Pa 621 Ridgely Ave Suite 202 Annapolis MD 21401-1081 Ph: (410) 897-1931 | Marla Kush Prokop, Dmd, Pa 621 Ridgely Ave Suite 202 Annapolis MD 21401-1081 Ph: (410) 897-1931 |
| NPI Number | 1194949214 |
|---|---|
| Provider Enumeration Date | 04/12/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194949214 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 12877 (Maryland) | Primary |
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