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Organization

PS DENTAL DC 1, P.C.

Active
Parent organization
PROSMILE HOLDING II LLC
Organization subpart
Yes

Provider details

NPI number
Legal business name
PROSMILE HOLDING II LLC
Authorized official
MRS. SIMONE WILSON MPA (DIRECTOR OF CREDENTIALING)
(848) 326-8840
Entity
Organization

Contact information

Practice address
4740 CONNECTICUT AVE NW APT 102, WASHINGTON, DC 20008-5604
(410) 761-0095
(202) 364-3274
Mailing address
10 WOODBRIDGE CENTER DR STE 520, WOODBRIDGE, NJ 07095-1152
(848) 326-8840

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary

Other

Enumeration date
03/20/2023
Last updated
11/10/2025
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