Provider Demographics
NPI:1801274642
Name:BEL PRE FAMILY DENTAL LLC
Entity type:Organization
Organization Name:BEL PRE FAMILY DENTAL LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST/PRACTICE OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERNEST
Authorized Official - Middle Name:
Authorized Official - Last Name:PONRAJ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:301-598-7800
Mailing Address - Street 1:4 TAFT CT STE 150
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-5582
Mailing Address - Country:US
Mailing Address - Phone:301-598-7800
Mailing Address - Fax:301-963-6300
Practice Address - Street 1:4 TAFT CT STE 150
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-5582
Practice Address - Country:US
Practice Address - Phone:301-598-7800
Practice Address - Fax:301-963-6300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-13
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD147191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty