Provider Demographics
NPI:1043395205
Name:DIMITRIOS GAREFALAKIS DDS PA
Entity Type:Organization
Organization Name:DIMITRIOS GAREFALAKIS DDS PA
Other - Org Name:NOTTINGHAM DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DIMITRIOS
Authorized Official - Middle Name:
Authorized Official - Last Name:GAREFALAKIS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:410-256-3371
Mailing Address - Street 1:4134 E JOPPA RD
Mailing Address - Street 2:SUITE 104&105
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21236-2284
Mailing Address - Country:US
Mailing Address - Phone:410-256-3371
Mailing Address - Fax:410-256-6848
Practice Address - Street 1:4134 E JOPPA RD
Practice Address - Street 2:SUITE 104&105
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21236-2284
Practice Address - Country:US
Practice Address - Phone:410-256-3371
Practice Address - Fax:410-256-6848
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-26
Last Update Date:2009-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD12207261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental