Organization
SMILE STATION KIDS DENTISTRY AND ORTHODONTICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CASSANDRA WIETH (DIRECTOR OF PAYOR RELATIONS)
(623) 267-8121
Entity
Organization
Contact information
Practice address
1201 DUTCHMANS CREEK DR STE A-B, BRUNSWICK, MD 21716-9770
(301) 900-4981
Mailing address
1201 DUTCHMANS CREEK DR STE A-B, BRUNSWICK, MD 21716-9770
(301) 900-4981
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
Other
Enumeration date
10/28/2025
Last updated
10/28/2025
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