Organization
KIDS TEETH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. NAZY HACKER (OFFICE MANAGER)
(301) 330-3222
Entity
Organization
Contact information
Practice address
15200 SHADY GROVE RD, SUITE #450, ROCKVILLE, MD 20850-3218
(301) 330-3222
(301) 330-3113
Mailing address
15200 SHADY GROVE RD, SUITE #450, ROCKVILLE, MD 20850-3218
(301) 330-3222
(301) 330-3113
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
12149
MD
Other
Enumeration date
06/30/2008
Last updated
06/30/2008
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