Organization
DENTRUST DENTAL MARYLAND, P.A.
Active
Parent organization
DENTRUST DENTAL MARYLAND, PA
Other names
DOCS Dental Ft. Meade
Organization subpart
Yes
Provider details
NPI number
Legal business name
DENTRUST DENTAL MARYLAND, PA
Authorized official
AMANDA ANNE CLARK (DIRECTOR OF CREDENTALING)
(267) 927-5000
Entity
Organization
Contact information
Practice address
2799 ROSE ST BLDG 685, FORT GEORGE G MEADE, MD 20755-5140
(267) 927-5000
Mailing address
2799 ROSE ST BLDG 685, FORT GEORGE G MEADE, MD 20755-5140
(267) 927-5000
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10988
DENTISTRY
MD
Enumeration date
01/23/2023
Last updated
02/08/2023
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