Provider Demographics
NPI:1871834234
Name:HYPERION DENTAL MANAGEMENT, LLC
Entity Type:Organization
Organization Name:HYPERION DENTAL MANAGEMENT, LLC
Other - Org Name:ALPHA DENTAL EXCELLENCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KERRY
Authorized Official - Middle Name:F
Authorized Official - Last Name:CROCKEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:410-441-9400
Mailing Address - Street 1:122 N PHILADELPHIA BLVD
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:MD
Mailing Address - Zip Code:21001-2513
Mailing Address - Country:US
Mailing Address - Phone:410-272-2636
Mailing Address - Fax:
Practice Address - Street 1:122 N PHILADELPHIA BLVD
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:MD
Practice Address - Zip Code:21001-2513
Practice Address - Country:US
Practice Address - Phone:410-272-2636
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-11
Last Update Date:2013-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
12762122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty