Provider Demographics
NPI:1437796802
Name:WELLWOOD FAMILY DENTISTRY LLC
Entity Type:Organization
Organization Name:WELLWOOD FAMILY DENTISTRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:ELIOT
Authorized Official - Middle Name:
Authorized Official - Last Name:EINBINDER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:646-265-5336
Mailing Address - Street 1:2835 SMITH AVE STE A
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-1454
Mailing Address - Country:US
Mailing Address - Phone:410-709-3293
Mailing Address - Fax:
Practice Address - Street 1:2835 SMITH AVE STE A
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21209-1454
Practice Address - Country:US
Practice Address - Phone:410-709-3293
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-04
Last Update Date:2019-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental