Organization
PRESIDENTIAL PEDIATRIC DENTISTRY & ORTHODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KIDANEMARIAM ROZARIO (PRACTICE MANAGER)
(202) 248-6288
Entity
Organization
Contact information
Practice address
350 EASTERN AVE NE, WASHINGTON, DC 20019-2833
(202) 248-6288
(202) 248-6330
Mailing address
350 EASTERN AVE NE, WASHINGTON, DC 20019-2833
(202) 248-6288
(202) 248-6330
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DEN1001643
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
058025400
—
DC
Enumeration date
05/04/2017
Last updated
05/04/2017
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