Provider Demographics
NPI:1780108472
Name:TANEY DENTAL ASSOCIATES, LLC
Entity type:Organization
Organization Name:TANEY DENTAL ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CONNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BOWERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-756-4373
Mailing Address - Street 1:438 E BALTIMORE ST
Mailing Address - Street 2:
Mailing Address - City:TANEYTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21787-2304
Mailing Address - Country:US
Mailing Address - Phone:410-756-4373
Mailing Address - Fax:410-751-1774
Practice Address - Street 1:438 E BALTIMORE ST
Practice Address - Street 2:
Practice Address - City:TANEYTOWN
Practice Address - State:MD
Practice Address - Zip Code:21787-2304
Practice Address - Country:US
Practice Address - Phone:410-756-4373
Practice Address - Fax:410-751-1774
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty