Provider Demographics
NPI:1033657986
Name:CPDG,AB, LLC
Entity Type:Organization
Organization Name:CPDG,AB, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HAKAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KOYMEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:410-248-3384
Mailing Address - Street 1:3400 BOX HILL CORPORATE CENTER DRIVE
Mailing Address - Street 2:SUITE 120
Mailing Address - City:ABINGDON
Mailing Address - State:MD
Mailing Address - Zip Code:21009
Mailing Address - Country:US
Mailing Address - Phone:410-248-3384
Mailing Address - Fax:
Practice Address - Street 1:3400 BOX HILL CORPORATE CENTER DRIVE
Practice Address - Street 2:SUITE 120
Practice Address - City:ABINGDON
Practice Address - State:MD
Practice Address - Zip Code:21009
Practice Address - Country:US
Practice Address - Phone:410-248-3384
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHESAPEAKE PEDIATRIC DENTAL GROUP, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-02-10
Last Update Date:2017-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD127701223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty