Provider Demographics
NPI:1912304346
Name:CLARKSVILLE CROSSING DENTAL, LLC
Entity Type:Organization
Organization Name:CLARKSVILLE CROSSING DENTAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:COLLIN
Authorized Official - Last Name:STEINWEG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:410-531-2600
Mailing Address - Street 1:6355 TEN OAKS RD
Mailing Address - Street 2:201
Mailing Address - City:CLARKSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21029-1185
Mailing Address - Country:US
Mailing Address - Phone:410-531-2600
Mailing Address - Fax:410-531-2694
Practice Address - Street 1:6355 TEN OAKS RD
Practice Address - Street 2:201
Practice Address - City:CLARKSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21029-1185
Practice Address - Country:US
Practice Address - Phone:410-531-2600
Practice Address - Fax:410-531-2694
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-01
Last Update Date:2014-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD15000122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty