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General NPI Number Information
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NPI Number | 1003782053
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Entity Type | Organization
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Legal Business Name | CENTERS FOR ADVANCED ENT CARE, LLC
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Dates
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Enumeration Date | 10/16/2025
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Last Update Date | 10/29/2025
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Provider Practice Location Address
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Address Line | 163 THOMAS JOHNSON DR STE H
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City | FREDERICK
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State | MD
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Zip | 21702-4673
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Country | US
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Telephone | 301-739-0402
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Fax |
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Provider Business Mailing Address
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Address Line | 6701 DEMOCRACY BLVD STE 300
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City | BETHESDA
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State | MD
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Zip | 20817-7500
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | MARC G DUBIN
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Credential |
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Telephone | 410-821-5151
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number |
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License Number State |
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