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Organization

SIMPLE MIRACLES DENTISTRY, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SHANA A DICKS (GENERAL DENTIST)
(301) 383-0958
Entity
Organization

Contact information

Practice address
16900 SCIENCE DR STE 110, BOWIE, MD 20715-4465
(301) 383-0958
(240) 487-5161
Mailing address
16900 SCIENCE DR STE 110, BOWIE, MD 20715-4465
(301) 383-0958
(240) 487-5161

Taxonomy

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

Other

Enumeration date
09/19/2023
Last updated
12/11/2023
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