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Organization
VANGUARD ORTHODONTICS LLC
Active
Organization
VANGUARD ORTHODONTICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID BYRON BONEBREAK DDS (OWNER)
(410) 381-1077
Entity
Organization
Contact information
Practice address
8191 MAPLE LAWN BLVD STE E, FULTON, MD 20759-2535
(410) 381-1077
Mailing address
12240 PLEASANT SPRINGS CT, FULTON, MD 20759-9647
(443) 956-5814
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
14232
MD
261QD0000X
Dental Clinic/Center
6368
MD
Other
Enumeration date
12/08/2017
Last updated
03/17/2018
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