Organization
GD MD SHADY GROVE LLC
Active
Other names
Callahan Dental
Organization subpart
No
Provider details
NPI number
Authorized official
CHAD HENDRICKS (CREDENTIALING)
(612) 859-0444
Entity
Organization
Contact information
Practice address
15225 SHADY GROVE RD STE 301, ROCKVILLE, MD 20850-3296
(301) 948-1212
Mailing address
15225 SHADY GROVE RD STE 301, ROCKVILLE, MD 20850-3296
(301) 948-1212
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
05/06/2024
Last updated
05/06/2024
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