Organization
NOVA DENTAL GAITHERSBURG LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DMITRY NOVA DDS (OWNER/MEMBER)
(240) 477-8006
Entity
Organization
Contact information
Practice address
806 W DIAMOND AVE STE 300, GAITHERSBURG, MD 20878-1415
(240) 477-8006
(240) 477-7944
Mailing address
806 W DIAMOND AVE STE 300, GAITHERSBURG, MD 20878-1415
(240) 477-8006
(240) 477-7944
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
11190
MD
Other
Enumeration date
07/19/2015
Last updated
07/19/2015
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