Organization
AUDUBON DENTAL CENTER OF CLINTON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMATHA C. PANTANO DMO (OWNER)
(301) 856-1122
Entity
Organization
Contact information
Practice address
8918 WOODYARD RD, CLINTON, MD 20735
(301) 856-1122
(301) 856-1759
Mailing address
8918 WOODYARD RD, CLINTON, MD 20735
(301) 856-1122
(301) 856-1759
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
049843200
—
MD
Enumeration date
12/11/2019
Last updated
12/11/2019
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