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Organization
CAPITAL DME
Active
Organization
CAPITAL DME
Active
Parent organization
CREATIVE SMILE INSTITUTE, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
CREATIVE SMILE INSTITUTE, LLC
Authorized official
DR. OLUWOLE AJAGBE DDS (OWNER)
(202) 239-7108
Entity
Organization
Contact information
Practice address
3636 16TH ST NW, SUITE AG 13, WASHINGTON, DC 20010-1146
(202) 239-7108
Mailing address
3636 16TH ST NW, SUITE AG 13, WASHINGTON, DC 20010-1146
(202) 239-7108
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
5263
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01801200
—
DC
Enumeration date
03/30/2017
Last updated
03/30/2017
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