Organization
BANA BALL DMD LLC
Active
Other names
Shady Grove Pediatric Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BANAFSHEH M BALL DMD (PEDIATRIC DENTIST; OWNER)
(240) 848-7074
Entity
Organization
Contact information
Practice address
15245 SHADY GROVE RD STE 260, ROCKVILLE, MD 20850-3222
(240) 848-7074
(240) 848-7075
Mailing address
15609 WAPELLO WAY, ROCKVILLE, MD 20855-2642
(423) 737-8208
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
10/30/2019
Last updated
10/30/2019
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