| NPI | 1275902298 |
|---|---|
| Doing Business As | SEVERN RIVER DENTAL HEALTH CENTER |
| Entity Type | Organization |
| Authorized Contact | YEREMI ANTONIO CANIZALES Owner 410-647-4094 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MD 14933) |
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: MD 14819) |
| 124Q00000X Dental Hygienist (Licence: MD 6912) | |
| Enumeration Date | 2015-09-21 |
| Last Update Date | 2019-08-09 |