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General NPI Number Information
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NPI Number | 1013303403
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Entity Type | Organization
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Legal Business Name | 3D ORAL & MAXILLOFACIAL IMAGING CENTER, LLC
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Dates
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Enumeration Date | 04/13/2015
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Last Update Date | 04/13/2015
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Provider Practice Location Address
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Address Line | 11125 ROCKVILLE PIKE STE 211
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City | NORTH BETHESDA
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State | MD
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Zip | 20852-3142
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Country | US
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Telephone | 240-221-0797
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Fax | 240-560-5358
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Provider Business Mailing Address
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Address Line | 11125 ROCKVILLE PIKE STE 211
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City | NORTH BETHESDA
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State | MD
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Zip | 20852-3142
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Country | US
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Telephone | 240-221-0797
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JUDY H. OH
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Credential | D.D.S.
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Telephone | 240-221-0797
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 14334
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License Number State | MD
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