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Organization
CCDENTAL, LLC
Active
Organization
CCDENTAL, LLC
Active
Parent organization
CCDENTAL, LLC
Other names
Key City Dental Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
CCDENTAL, LLC
Authorized official
DR. MICHAEL PESIN DDS (PARTNER)
(301) 378-2595
Entity
Organization
Contact information
Practice address
7810 WORMANS MILL ROAD, STE D, FREDERICK, MD 21701
(301) 378-2595
(301) 378-2729
Mailing address
7810 WORMANS MILL ROAD, STE D, FREDERICK, MD 21701
(013) 378-2595
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
10/24/2024
Last updated
10/24/2024
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