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Organization

BETHESDA CHEVY CHASE DENTAL CARE

Active
Other names
Supertooth Dental Group
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BEN MANESH (OWNER / OPERATOR)
(301) 986-8777
Entity
Organization

Contact information

Practice address
6831 WISCONSIN AVE, P101, CHEVY CHASE, MD 20815-6122
(301) 986-8777
(301) 986-8873
Mailing address
6831 WISCONSIN AVE, P101, CHEVY CHASE, MD 20815-6122
(301) 986-8777
(301) 986-8873

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1223P0300X
Periodontics
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
124Q00000X
Dental Hygienist
126800000X
Dental Assistant

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
039934100
DC
Enumeration date
08/16/2013
Last updated
08/16/2013
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