| Edmondson Dental Center For Maryland Public Health, Inc | |
|
170 Miller St Grantsville MD 21536-1383 | |
| (301) 895-5780 | |
| Not Available |
| Full Name | Edmondson Dental Center For Maryland Public Health, Inc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 170 Miller St, Grantsville, Maryland |
| Authorized Official Name and Position | C.w. Edmondson (PRESIDENT) |
| Authorized Official Contact | 3018955780 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Edmondson Dental Center For Maryland Public Health, Inc 170 Miller St Grantsville MD 21536-1383 Ph: (301) 895-5780 | Edmondson Dental Center For Maryland Public Health, Inc 170 Miller St Grantsville MD 21536-1383 Ph: (301) 895-5780 |
| NPI Number | 1821384314 |
|---|---|
| Provider Enumeration Date | 06/22/2011 |
| Last Update Date | 03/26/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821384314 | NPI | - | NPPES |
| 039320700 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 13821 (Maryland) | Primary |