Petra Dentistry LLC

NPI #1598850422 in Columbia, Maryland

Provider Information

NPI Number: 1598850422
Entity Type: Organization
Organization Name: Petra Dentistry LLC
Primary Specialty: Dentist - General Practice
Enumeration Date: Oct 4, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 10910 LITTLE PATUXENT PKWY
Address 2: SUITE 206
City: Columbia
State: Maryland
ZIP Code: 21044-3078
Phone: (410) 740-8588

Authorized Official

Name: LARA E PHILIPPI, D.M.D.
Title: DENTIST/OWNER
Phone: (410) 740-8588

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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