Organization
AEGIS DENTAL GROUP LLC (DBA SMILES4ALL)
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICARDO ANTHONY HECTOR DDS (OWNER/ DENTIST)
(301) 310-4851
Entity
Organization
Contact information
Practice address
12092 ELL LN, WALDORF, MD 20602-3522
(301) 645-7777
Mailing address
12092 ELL LN, WALDORF, MD 20602-3522
(301) 645-7777
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13764
DENTAL LICENSE
MD
Enumeration date
05/24/2019
Last updated
05/24/2019
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