Organization
SPECIALISTS IN ORTHODONTICS OF MARYLAND 3 LLC JERRY CASPER SOLE MBR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JO ANN RICE (CREDENTIALING MANAGER)
(609) 315-3851
Entity
Organization
Contact information
Practice address
9812 FALLS RD STE 118, POTOMAC, MD 20854-3918
(301) 517-6359
Mailing address
2970 BRANDYWINE RD STE 200, ATLANTA, GA 30341-5549
(770) 692-1000
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
261QD0000X
Dental Clinic/Center
—
—
Other
Enumeration date
02/04/2022
Last updated
02/04/2022
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