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Organization
BETHESDA CHEVY CHASE DENTAL CARE
Active
Organization
BETHESDA CHEVY CHASE DENTAL CARE
Active
Other names
Supertooth Dental Group
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BEN MANESH (OWNER / OPERATOR)
(301) 986-8777
Entity
Organization
Contact information
Practice address
6831 WISCONSIN AVE, P101, CHEVY CHASE, MD 20815-6122
(301) 986-8777
(301) 986-8873
Mailing address
6831 WISCONSIN AVE, P101, CHEVY CHASE, MD 20815-6122
(301) 986-8777
(301) 986-8873
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
1223P0300X
Periodontics
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
124Q00000X
Dental Hygienist
—
—
126800000X
Dental Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
039934100
—
DC
Enumeration date
08/16/2013
Last updated
08/16/2013
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