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Organization
SPECIALISTS IN ORTHODONTICS OF MARYLAND, LLC
Active
Organization
SPECIALISTS IN ORTHODONTICS OF MARYLAND, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JO ANN RICE (CREDENTIALING DIRECTOR)
(609) 315-3851
Entity
Organization
Contact information
Practice address
13600 BALTIMORE AVE STE 200, LAUREL, MD 20707-9495
(301) 470-2137
Mailing address
2970 BRANDYWINE RD STE 200, ATLANTA, GA 30341-5549
(770) 692-1000
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
07/18/2019
Last updated
10/12/2023
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