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Contact Information

KC GRANGER DDS PC
1211 ENTERPRISE RD
MITCHELLEVILLE, MD20721-1834
 Phone: 301-249-3333
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
 

Dental

261QD0000X
 

Endodontics

1223E0200X
 

Oral and Maxillofacial Surgery

261QS0112X
Indicates primary specialty

NPI Profile & details for KC GRANGER DDS PC

NPI # 1982914305
LBN Legal business name KC GRANGER DDS PC
Authorized official KEVIN GRANGER - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 10/19/2010
Last updated 10/25/2023 - About 3 years ago
Identifiers
MD License # 14112
MD Medicaid 39607900
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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