Provider Demographics
NPI:1508551318
Name:DENTAL GROUP OF BALTIMORE CITY
Entity Type:Organization
Organization Name:DENTAL GROUP OF BALTIMORE CITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:VLADIMIR
Authorized Official - Middle Name:
Authorized Official - Last Name:SEMEREY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-980-8263
Mailing Address - Street 1:300 N CHARLES ST STE D
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-4305
Mailing Address - Country:US
Mailing Address - Phone:410-685-0002
Mailing Address - Fax:
Practice Address - Street 1:300 N CHARLES ST STE D
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-4305
Practice Address - Country:US
Practice Address - Phone:410-685-0002
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-07
Last Update Date:2023-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty