Provider Demographics
NPI:1033948922
Name:UMG FAMILY DENTISTRY
Entity type:Organization
Organization Name:UMG FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LADY
Authorized Official - Middle Name:
Authorized Official - Last Name:UNG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:240-277-2619
Mailing Address - Street 1:5058 GAITHERS CHANCE DR
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21029-1486
Mailing Address - Country:US
Mailing Address - Phone:240-277-2619
Mailing Address - Fax:443-917-6638
Practice Address - Street 1:10715 LITTLE PATUXENT PKWY
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-3123
Practice Address - Country:US
Practice Address - Phone:443-917-6638
Practice Address - Fax:443-917-6639
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-29
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental