Organization
SMILE LOFT GAITHERSBURG LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINE RAI (HR DIRECTOR)
(410) 610-3071
Entity
Organization
Contact information
Practice address
9069 SHADY GROVE CT, GAITHERSBURG, MD 20877-1301
(301) 977-3766
Mailing address
9069 SHADY GROVE CT, GAITHERSBURG, MD 20877-1301
(301) 977-3766
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
12/16/2020
Last updated
12/16/2020
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