Provider Demographics
NPI:1225739659
Name:LEAH K ROMAY DDS PA LLC
Entity Type:Organization
Organization Name:LEAH K ROMAY DDS PA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LEAH
Authorized Official - Middle Name:K
Authorized Official - Last Name:ROMAY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:410-833-4664
Mailing Address - Street 1:PO BOX 205
Mailing Address - Street 2:
Mailing Address - City:GLYNDON
Mailing Address - State:MD
Mailing Address - Zip Code:21071-0205
Mailing Address - Country:US
Mailing Address - Phone:410-833-4664
Mailing Address - Fax:
Practice Address - Street 1:4817 BUTLER RD
Practice Address - Street 2:
Practice Address - City:GLYNDON
Practice Address - State:MD
Practice Address - Zip Code:21071-2100
Practice Address - Country:US
Practice Address - Phone:410-833-4664
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-13
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1558971325OtherNPI1
MD1316462146OtherNPI1