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General NPI Number Information
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NPI Number | 1033683024
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Entity Type | Organization
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Legal Business Name | CENTER FOR ADVANCED DENTISTRY LLC
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Dates
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Enumeration Date | 01/14/2019
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Last Update Date | 11/10/2025
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Provider Practice Location Address
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Address Line | 10301 GEORGIA AVE STE 307
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City | SILVER SPRING
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State | MD
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Zip | 20902-5020
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Country | US
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Telephone | 301-593-4200
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Fax | 301-754-1614
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Provider Business Mailing Address
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Address Line | 10301 GEORGIA AVE STE 307
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City | SILVER SPRING
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State | MD
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Zip | 20902-5020
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Country | US
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Telephone | 301-593-4200
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Fax | 301-754-1614
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. SHANNA ROSE MARK
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Credential | RN
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Telephone | 301-593-4200
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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 |
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License Number State |
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