Organization
MOUNTAIN CITY DENTAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JORDAN R HOBEL DDS (OWNER)
(301) 268-7797
Entity
Organization
Contact information
Practice address
16920 NATIONAL HWY SW, FROSTBURG, MD 21532-3306
(301) 689-3677
(301) 689-3477
Mailing address
16920 NATIONAL HWY SW, FROSTBURG, MD 21532-3306
(301) 689-3677
(301) 689-3477
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
16158
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
117263800
—
MD
Enumeration date
03/20/2018
Last updated
03/20/2018
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