Organization
TLC MODERN DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ROSANN RODRIGUEZ (OFFICE MANAGER)
(301) 208-0002
Entity
Organization
Contact information
Practice address
18220 CONTOUR RD, MONTGOMERY VILLAGE, MD 20877-2623
(301) 208-0002
Mailing address
18220 CONTOUR RD, MONTGOMERY VILLAGE, MD 20877-2623
(301) 208-0002
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
15202
MD
Other
Enumeration date
11/04/2013
Last updated
11/04/2013
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