Provider Demographics
NPI:1356463558
Name:NARLIS DENTAL PA
Entity Type:Organization
Organization Name:NARLIS DENTAL PA
Other - Org Name:FAMILY, COSMETIC AND IMPLANT DENTISTRY
Other - Org Type:Other Name
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:NARLIS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:410-472-9650
Mailing Address - Street 1:913 RIDGEBROOK RD
Mailing Address - Street 2:SUITE 206
Mailing Address - City:SPARKS
Mailing Address - State:MD
Mailing Address - Zip Code:21152-9455
Mailing Address - Country:US
Mailing Address - Phone:410-472-9650
Mailing Address - Fax:410-472-9653
Practice Address - Street 1:913 RIDGEBROOK RD
Practice Address - Street 2:SUITE 206
Practice Address - City:SPARKS
Practice Address - State:MD
Practice Address - Zip Code:21152-9455
Practice Address - Country:US
Practice Address - Phone:410-472-9650
Practice Address - Fax:410-472-9653
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD13415261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental