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Organization

CCDENTAL, LLC

Active
Parent organization
CCDENTAL, LLC
Other names
Key City Dental Care
Organization subpart
Yes

Provider details

NPI number
Legal business name
CCDENTAL, LLC
Authorized official
DR. MICHAEL PESIN DDS (PARTNER)
(301) 378-2595
Entity
Organization

Contact information

Practice address
7810 WORMANS MILL ROAD, STE D, FREDERICK, MD 21701
(301) 378-2595
(301) 378-2729
Mailing address
7810 WORMANS MILL ROAD, STE D, FREDERICK, MD 21701
(013) 378-2595

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary

Other

Enumeration date
10/24/2024
Last updated
10/24/2024
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