Individual
DR. CAROLE S BURGESS-FONGSAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
17810 MEETING HOUSE RD, MOORE BLDG # 205, SANDY SPRING, MD 20860-1038
(301) 774-3847
(301) 774-4528
Mailing address
17810 MEETING HOUSE RD, MOORE BLDG # 205, SANDY SPRING, MD 20860-1038
(301) 774-3847
(301) 774-4528
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
9667
MD
Other
Enumeration date
05/06/2010
Last updated
03/14/2016
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