Healthcare Provider Details

I. General information

NPI: 1861368813
Provider Name (Legal Business Name): CENTERS FOR ADVANCED ENT CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2025
Last Update Date: 10/16/2025
Certification Date: 10/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3204 TOWER OAKS BLVD STE 400
ROCKVILLE MD
20852-4250
US

IV. Provider business mailing address

6701 DEMOCRACY BLVD STE 300
BETHESDA MD
20817-7500
US

V. Phone/Fax

Practice location:
  • Phone: 301-315-0003
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207YS0123X
TaxonomyFacial Plastic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number State

VIII. Authorized Official

Name: MARC G DUBIN
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 410-821-5151