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General NPI Number Information
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NPI Number | 1023642345
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Entity Type | Organization
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Legal Business Name | BESTADENTAL LLC
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Dates
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Enumeration Date | 02/25/2020
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Last Update Date | 02/25/2020
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Provider Practice Location Address
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Address Line | 15204 OMEGA DR STE 250
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City | ROCKVILLE
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State | MD
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Zip | 20850-4601
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Country | US
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Telephone | 240-580-8818
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Fax | 240-580-8819
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Provider Business Mailing Address
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Address Line | 15204 OMEGA DR STE 250
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City | ROCKVILLE
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State | MD
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Zip | 20850-4601
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Country | US
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Telephone | 240-580-8818
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Fax | 240-580-8819
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | DR. LIANG FANG
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Credential | DMD
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Telephone | 443-763-6657
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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