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Organization

OCTAVIA SIMKINS-WISEMAN DDS PC

Active
Other names
Mitchellville Family Dentistry
Organization subpart
No

Provider details

NPI number
Authorized official
DR. OCTAVIA SIMKINS-WISEMAN DDS (CEO)
(240) 393-9861
Entity
Organization

Contact information

Practice address
12150 ANNAPOLIS ROAD, SUITE 301, GLENN DALE, MD 20769
(301) 249-8000
(301) 249-4958
Mailing address
12150 ANNAPOLIS ROAD, SUITE 301, GLENN DALE, MD 20769
(301) 249-2862
(301) 249-4958

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
10983
MD

Other

Enumeration date
03/29/2012
Last updated
03/18/2013
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