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Organization

WESTPHALIA DENTAL CARE, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. MARK VAN RUSSELL (VP OF OPERATIONS)
(240) 320-7331
Entity
Organization

Contact information

Practice address
9632 MARLBORO PIKE, UPPER MARLBORO, MD 20772
(240) 838-7568
(301) 576-5800
Mailing address
9632 MARLBORO PIKE, UPPER MARLBORO, MD 20772
(240) 838-7568
(301) 576-5800

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
14531
MD

Other

Enumeration date
07/15/2014
Last updated
07/15/2014
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