Healthcare Provider Details
I. General information
NPI: 1487520334
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
3801 INTERNATIONAL DR STE 206
SILVER SPRING MD
20906-1550
US
IV. Provider business mailing address
6701 DEMOCRACY BLVD STE 300
BETHESDA MD
20817-7500
US
V. Phone/Fax
- Phone: 301-774-0074
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Y00000X |
| Taxonomy | Otolaryngology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MARC
G
DUBIN
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 410-821-5151