Organization
PEDIATRIC DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSE JUAMBELTZ DDS (OWNER)
(410) 257-7676
Entity
Organization
Contact information
Practice address
23140 MOAKLEY ST STE 3, LEONARDTOWN, MD 20650-2923
(301) 997-1800
(301) 997-0402
Mailing address
23140 MOAKLEY ST STE 3, LEONARDTOWN, MD 20650-2923
(301) 997-1800
(301) 997-0402
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
11/08/2023
Last updated
11/08/2023
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