Organization
A GREAT SMILE DENTAL CARE PLLC
Active
Other names
water brook dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARLENE SAINT-PHARD SHAW D.D.S. (OWNER)
(202) 726-5106
Entity
Organization
Contact information
Practice address
2750 14TH ST NW, C-11, WASHINGTON, DC 20009-6909
(202) 726-5106
(202) 882-0976
Mailing address
7826 EASTERN AVE NW, SUITE 301, WASHINGTON, DC 20012-1324
(202) 726-5106
(202) 882-0976
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DEN1000381
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
012049900
—
MD
05
—
037396400
—
DC
Enumeration date
08/15/2011
Last updated
08/15/2011
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