Organization
NUCLEAR SMILES LLC
Active
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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