Kc Granger Dds Pc

LBN: Kc Granger Dds Pc
Kc Granger Dds Pc is an health care organization with primary practice located at 1211 Enterprise Rd , Mitchelleville MD 20721-1834. The organization recently has 4 registered licenses in different health care specialties including Dental Providers / Endodontics, Dental Providers / General Practice, Ambulatory Health Care Facilities / Dental, Ambulatory Health Care Facilities / Oral and Maxillofacial Surgery. Dental Providers / General Practice is the primary health care specialty. Kc Granger Dds Pc can be contacted via phone (301) 249-3333, or through Granger, Kevin via phone (301) 249-3333.

Contact Information

Primary practice address
1211 Enterprise Rd Mitchelleville MD 20721-1834
Phone: (301) 249-3333
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Granger, Kevin Doctor of Dental Surgery (DDS)
Phone: (301) 249-3333

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Endodontics 1223E0200X
Dental Providers / General Practice 1223G0001X 14112 Maryland
Ambulatory Health Care Facilities / Dental 261QD0000X
Ambulatory Health Care Facilities / Oral and Maxillofacial Surgery 261QS0112X

Profile Details

NPI number 1982914305
LBN Legal business name Kc Granger Dds Pc
DBA Doing business as
Authorized official Granger, Kevin Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date Oct 19th, 2010
Last updated Oct 25th, 2023 - about last year

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1982914305 NPPES
Maryland MEDICAID 39607900

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