Organization
TOMELL DUBOSE DDS PLLC
Active
Other names
Connecticut ave Dental Implant center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TOMELL DUBOSE DR (CEO)
(202) 364-6550
Entity
Organization
Contact information
Practice address
5437 CONN AVE NW APT 203, WASHINGTON, DC 20015-2706
(202) 364-6550
(202) 478-2894
Mailing address
5437 CONNECTICUT AVE NW APT 203, WASHINGTON, DC 20015-2706
(202) 364-6550
(202) 478-2894
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12345
PRIVATE PRACTICE
DC
Enumeration date
07/08/2019
Last updated
07/08/2019
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