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General NPI Number Information
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NPI Number | 1114421062
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Entity Type | Organization
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Legal Business Name | DENTAL HEALTH OF DC PLLC
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Dates
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Enumeration Date | 03/23/2018
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Last Update Date | 03/23/2018
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Provider Practice Location Address
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Address Line | 3130 MARTIN LUTHER KING JR AVE SE
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City | WASHINGTON
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State | DC
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Zip | 20032-1503
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Country | US
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Telephone | 202-562-6340
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Fax | 202-562-6342
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Provider Business Mailing Address
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Address Line | 3130 MARTIN LUTHER KING JR AVE SE
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City | WASHINGTON
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State | DC
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Zip | 20032-1503
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Country | US
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Telephone | 202-562-6340
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Fax | 202-562-6342
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | CHRISTEL GRETA NEWSOME
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Credential |
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Telephone | 202-562-6340
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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