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NPI Code Detail

MEDICARE: ORAL HEALTH GUARDIANS, LLC

MEDICARE: ORAL HEALTH GUARDIANS, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223P0221XPediatric Dentistry

General Provider Information

NPI Number : 1427719434
Entity Type Code : Organization
Provider Name (Legal Business Name) : ORAL HEALTH GUARDIANS, LLC
Provider Business Mailing Address
First Line : 4451 TELFAIR BLVD APT 5023
Second Line :
City : CAMP SPRINGS
State : MD
Zip : 20746-5265
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4400 TELFAIR BLVD STE A1
Second Line :
City : CAMP SPRINGS
State : MD
Zip : 20746-5217
Country : US
Telephone Number : 301-848-6502
Fax Number :
Authorized Official
Title or Position : PEDIATRIC DENTIST
Name : DR. NICHOLAS GORDON
Credential : DMD
Telephone Number : 301-848-6502
Provider Enumeration Date : 01/03/2022
Last Update Date : 01/03/2022

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Directions to “ORAL HEALTH GUARDIANS, LLC ” Practice Location

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