Organization
MARLBOROUGH VILLAGE ORTHODONTICS
Active
Organization
MARLBOROUGH VILLAGE ORTHODONTICS
Active
Parent organization
MARLBOROUGH VILLAGE PEDIATRIC DENTAL
Organization subpart
Yes
Provider details
NPI number
Legal business name
MARLBOROUGH VILLAGE PEDIATRIC DENTAL
Authorized official
DR. ADRIAN JOHNSTON WILSON DDS (DENTIST/OWNER)
(443) 280-0968
Entity
Organization
Contact information
Practice address
5098 BROWN STATION ROAD SUITE 260, UPPER MARLBORO, MD 20772
(240) 326-3738
Mailing address
14300 RIDGE VIEW LANE, LAUREL, MD 20707
(443) 280-0968
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
09/16/2022
Last updated
09/16/2022
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