Provider Demographics
NPI:1093394793
Name:BK DENTAL LLC
Entity Type:Organization
Organization Name:BK DENTAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NARAYANI
Authorized Official - Middle Name:K
Authorized Official - Last Name:BALIGA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:301-747-6543
Mailing Address - Street 1:9815 MAIN ST STE 200
Mailing Address - Street 2:
Mailing Address - City:DAMASCUS
Mailing Address - State:MD
Mailing Address - Zip Code:20872-2099
Mailing Address - Country:US
Mailing Address - Phone:301-747-6547
Mailing Address - Fax:
Practice Address - Street 1:6550 MERCANTILE DR E STE 205
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21703-7657
Practice Address - Country:US
Practice Address - Phone:301-747-6543
Practice Address - Fax:855-202-0755
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-08
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental