Spa Creek Dental of MD LLC

NPI #1922533579 in Annapolis, Maryland

Provider Information

NPI Number: 1922533579
Entity Type: Organization
Organization Name: Spa Creek Dental of MD LLC
Primary Specialty: Dentist
Enumeration Date: Apr 20, 2017
Last Updated: Apr 20, 2017

Practice Location

Address: 185 ADMIRAL COCHRANE DR
Address 2: SUITE 117
City: Annapolis
State: Maryland
ZIP Code: 21401-7493
Phone: (757) 330-0766

Authorized Official

Name: KEITH DUNOFF, DMD
Title: SOLE MEMBER
Phone: (757) 330-0766

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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