NPI | 1093140501 |
---|---|
Doing Business As | GLEN BURNIE DENTAL CARE |
Former Legal Business Name | DENTAL PROFESSIONALS OF MARYLAND, GERALD AWADZI, PC |
Entity Type | Organization |
Authorized Contact | BRITTANY NICHELLE HOWARD Credentialing Affiliation Coordinat 217-540-8946 |
Organization Subpart ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2013-09-04 |
Last Update Date | 2019-08-13 |