Organization
RUSSELL PARK DENTAL CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VIGEN SIMCHIAN DDS (MEMBER)
(301) 284-8467
Entity
Organization
Contact information
Practice address
963 RUSSELL AVE STE A, GAITHERSBURG, MD 20879-3287
(301) 284-8467
Mailing address
963 RUSSELL AVE STE A, GAITHERSBURG, MD 20879-3287
(301) 284-8467
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
07/08/2020
Last updated
07/08/2020
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