# GO WEST MEDICAL DENTAL SERVICES LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174817811
- **Authorized official:** DR. JULIO J MENOCAL MD (OWNER)
- **Authorized official phone:** (240) 215-1138

## Contact information

- **Practice address:** 110 BAUGHMANS LN, SUITE 140, FREDERICK, MD 21702-4059
- **Practice address phone:** (240) 215-1138
- **Practice address fax:** (240) 215-1140
- **Mailing address:** PO BOX 1149, FREDERICK, MD 21702-0149

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | D31912 | MD | Yes |

## Other

- **Enumeration date:** 05/29/2011
- **Last updated:** 05/29/2011