| NPI | 1265971295 |
|---|---|
| Doing Business As | SEVERNA PARK DENTAL CARE |
| Former Legal Business Name | DENTAL PROFESSIONALS OF MARYLAND, GERALD AWADZI, P.C. |
| 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 | 2017-02-23 |
| Last Update Date | 2019-08-13 |