Organization
SUPREME DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES CHIU DMD (DENTIST)
(215) 350-8088
Entity
Organization
Contact information
Practice address
401 E JEFFERSON ST STE 104, ROCKVILLE, MD 20850-2617
(215) 350-8088
Mailing address
401 E JEFFERSON ST STE 104, ROCKVILLE, MD 20850-2617
(215) 350-8088
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
W15125180
—
MD
Enumeration date
12/31/2024
Last updated
12/31/2024
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