Provider Demographics
NPI:1568855682
Name:GOLDEN KEY DENTAL ,LLC
Entity Type:Organization
Organization Name:GOLDEN KEY DENTAL ,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JERON
Authorized Official - Middle Name:
Authorized Official - Last Name:SKERRITT-RYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-997-5007
Mailing Address - Street 1:11910 MARY CATHERINE DR
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735
Mailing Address - Country:US
Mailing Address - Phone:240-997-5007
Mailing Address - Fax:800-605-0459
Practice Address - Street 1:11910 MARY CATHERINE DR
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-1018
Practice Address - Country:US
Practice Address - Phone:240-997-5007
Practice Address - Fax:800-605-0459
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-13
Last Update Date:2015-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD12037261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental