Organization
SMILE LOFT NORTH POTOMAC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VAIBHAV RAI (MEMBER)
(610) 216-0339
Entity
Organization
Contact information
Practice address
12116 DARNESTOWN RD STE L1, NORTH POTOMAC, MD 20878-2227
(301) 258-7477
Mailing address
12116 DARNESTOWN RD STE L1, NORTH POTOMAC, MD 20878-2227
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
046068200
—
MD
Enumeration date
01/17/2023
Last updated
01/17/2023
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