Organization
NUCLEAR SMILES LLC
Active
Parent organization
THE VILLAGE ORTHODONTIST
Organization subpart
Yes
Provider details
NPI number
Legal business name
THE VILLAGE ORTHODONTIST
Authorized official
DR. JON A MOLES DDS (OWNER)
(301) 538-0719
Entity
Organization
Contact information
Practice address
10100 TWIN RIVERS RD APT 121, COLUMBIA, MD 21044-2578
(301) 538-0719
Mailing address
2104 DIXON RD, FREDERICK, MD 21704-8135
(301) 538-0719
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
11/26/2019
Last updated
11/26/2019
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