Organization
MISTY DENTAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DERRICK KENDILL EILAND DDS (DOCTOR/OWNER)
(202) 396-6100
Entity
Organization
Contact information
Practice address
419 34TH ST NE, WASHINGTON, DC 20019-1411
(202) 396-6100
(202) 388-0987
Mailing address
419 34TH ST NE, WASHINGTON, DC 20019-1411
(202) 396-6100
(202) 388-0987
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
Other
Enumeration date
05/21/2015
Last updated
05/21/2015
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