Organization
AVALON DENTAL CENTER, INC
Active
Other names
Avalon Dental Center, Inc
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MOFOLUSARA O OGUNFUSIKA DDS (DENTIST)
(301) 599-0404
Entity
Organization
Contact information
Practice address
9614 PENNSYLVANIA AVE, UPPER MARLBORO, MD 20772-3670
(301) 599-0404
(301) 599-1620
Mailing address
9614 PENNSYLVANIA AVE, UPPER MARLBORO, MD 20772-3670
(301) 599-0404
(301) 599-1620
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
11/03/2023
Last updated
11/03/2023
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