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General NPI Number Information
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NPI Number | 1093560468
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Entity Type | Organization
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Legal Business Name | THE FAMILY SMILE SHOP, LLC
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Dates
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Enumeration Date | 04/19/2024
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Last Update Date | 05/14/2024
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Provider Practice Location Address
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Address Line | 3060 MITCHELLVILLE RD STE 213
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City | BOWIE
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State | MD
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Zip | 20716-3972
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Country | US
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Telephone | 301-350-3932
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Fax | 301-350-7228
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Provider Business Mailing Address
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Address Line | 3060 MITCHELLVILLE RD STE 213
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City | BOWIE
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State | MD
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Zip | 20716-3972
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Country | US
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Telephone | 301-350-3932
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Fax | 301-350-7228
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Authorized Official
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Title or Position | OWNER
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Name | DR. BELINDA ANN CARVER-TAYLOR
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Credential | DDS
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Telephone | 301-350-6933
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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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