Provider Demographics
NPI:1457359242
Name:BAY DENTAL GROUP, L.L.C.
Entity Type:Organization
Organization Name:BAY DENTAL GROUP, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:F
Authorized Official - Last Name:PRIOR
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:301-862-3227
Mailing Address - Street 1:22738 MAPLE RD
Mailing Address - Street 2:SUITE 214
Mailing Address - City:LEXINGTON PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20653-3347
Mailing Address - Country:US
Mailing Address - Phone:301-862-3227
Mailing Address - Fax:301-862-3385
Practice Address - Street 1:22738 MAPLE RD
Practice Address - Street 2:SUITE 214
Practice Address - City:LEXINGTON PARK
Practice Address - State:MD
Practice Address - Zip Code:20653-3347
Practice Address - Country:US
Practice Address - Phone:301-862-3227
Practice Address - Fax:301-862-3385
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered1223E0200XDental ProvidersDentistEndodonticsGroup - Multi-Specialty
Not Answered1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty
Not Answered124Q00000XDental ProvidersDental HygienistGroup - Multi-Specialty