Provider Demographics
NPI:1013640325
Name:ASBA DENTAL , LLC
Entity Type:Organization
Organization Name:ASBA DENTAL , LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEDIATRIC DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BOSEDE
Authorized Official - Middle Name:
Authorized Official - Last Name:ADENIJI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:301-345-2881
Mailing Address - Street 1:7525 GREENWAY CENTER DR STE 102
Mailing Address - Street 2:
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-3525
Mailing Address - Country:US
Mailing Address - Phone:301-345-2881
Mailing Address - Fax:301-345-2882
Practice Address - Street 1:7525 GREENWAY CENTER DR STE 102
Practice Address - Street 2:
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-3525
Practice Address - Country:US
Practice Address - Phone:301-345-2881
Practice Address - Fax:301-345-2882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-05
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty