Organization
CHILDREN'S CHOICE PEDIATRIC DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONELLE GRANT-ANAMELECHI DDS (OWNER)
(919) 641-2676
Entity
Organization
Contact information
Practice address
8500 ANNAPOLIS RD STE 213, NEW CARROLLTON, MD 20784-3020
(301) 731-8510
Mailing address
8500 ANNAPOLIS RD STE 213, NEW CARROLLTON, MD 20784-3020
(301) 731-8510
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
14623
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14623
DENTAL BOARD
MD
Enumeration date
08/23/2017
Last updated
08/23/2017
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