| Mayo Dental Llc | |
|
55 Mayo Rd Ste 1 Edgewater MD 21037-1805 | |
| (410) 956-6626 | |
| (877) 310-6316 |
| Full Name | Mayo Dental Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 55 Mayo Rd Ste 1, Edgewater, Maryland |
| Authorized Official Name and Position | Puneeta Keer (DENTAL PROVIDER) |
| Authorized Official Contact | 4109566626 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mayo Dental Llc 55 Mayo Rd Ste 1 Edgewater MD 21037-1805 Ph: (410) 956-6626 | Mayo Dental Llc 55 Mayo Rd Ste 1 Edgewater MD 21037-1805 Ph: (410) 956-6626 |
| NPI Number | 1760760367 |
|---|---|
| Provider Enumeration Date | 07/30/2011 |
| Last Update Date | 03/14/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760760367 | NPI | - | NPPES |
| 012378100 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 13264 (Maryland) | Primary |
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