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General NPI Number Information
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NPI Number | 1033749346
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Entity Type | Organization
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Legal Business Name | MIDCOUNTY DENTAL CARE LLC
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Dates
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Enumeration Date | 01/26/2020
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Last Update Date | 01/26/2020
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Provider Practice Location Address
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Address Line | 18209 FLOWER HILL WAY STE A
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City | GAITHERSBURG
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State | MD
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Zip | 20879-5331
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Country | US
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Telephone | 240-632-8396
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Fax | 240-632-8399
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Provider Business Mailing Address
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Address Line | 18209 FLOWER HILL WAY STE A
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City | GAITHERSBURG
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State | MD
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Zip | 20879-5331
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Country | US
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Telephone | 301-873-2475
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Fax | 240-632-8399
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Authorized Official
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Title or Position | OWNER
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Name | PETER A WINKELMAN
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Credential | DDS
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Telephone | 301-873-2475
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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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