Organization
DENTAL GALLERIA OF BEAUTIFUL SMILES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHNETTE BROCK DDS (PRESIDENT)
(301) 588-3083
Entity
Organization
Contact information
Practice address
8737 COLESVILLE RD, SUITE LL105, SILVER SPRING, MD 20910-3928
(301) 588-3083
(301) 588-3084
Mailing address
8737 COLESVILLE RD, SUITE LL105, SILVER SPRING, MD 20910-3928
(301) 588-3083
(301) 588-3084
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12758
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
011819200
—
MD
05
—
039279700
—
DC
Enumeration date
04/08/2008
Last updated
04/08/2008
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