Provider Demographics
NPI:1073682548
Name:KOVAL DENTISTRY SERVICES, P.C.
Entity Type:Organization
Organization Name:KOVAL DENTISTRY SERVICES, P.C.
Other - Org Name:FAMILY DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHKOLNIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-581-3012
Mailing Address - Street 1:20 CROSSROADS DR STE 216
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-5481
Mailing Address - Country:US
Mailing Address - Phone:410-581-3012
Mailing Address - Fax:410-581-3045
Practice Address - Street 1:20 CROSSROADS DR STE 216
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-5481
Practice Address - Country:US
Practice Address - Phone:410-581-3012
Practice Address - Fax:410-581-3045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD6580OtherDENTAL NETWORK
MD1803483OtherUNITED CONCORDIA