Organization
SPECIALISTS IN ORTHODONTICS OF MARYLAND, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JO ANN RICE (CREDENTIALING DIRECTOR)
(609) 315-3851
Entity
Organization
Contact information
Practice address
13600 BALTIMORE AVE STE 200, LAUREL, MD 20707-9495
(301) 470-2137
Mailing address
2970 BRANDYWINE RD STE 200, ATLANTA, GA 30341-5549
(770) 692-1000
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
07/18/2019
Last updated
10/12/2023
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