Provider Demographics
NPI:1619033008
Name:GREATER MARYLAND DENTAL PARTNERS-COLUMBIA
Entity Type:Organization
Organization Name:GREATER MARYLAND DENTAL PARTNERS-COLUMBIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:BOB
Authorized Official - Middle Name:
Authorized Official - Last Name:HAUSLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-997-2400
Mailing Address - Street 1:10840 LITTLE PATUXENT PKWY STE 303
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-3142
Mailing Address - Country:US
Mailing Address - Phone:410-997-2400
Mailing Address - Fax:
Practice Address - Street 1:10840 LITTLE PATUXENT PKWY STE 303
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-3142
Practice Address - Country:US
Practice Address - Phone:410-997-2400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty