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General NPI Number Information
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NPI Number | 1194250209
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Entity Type | Organization
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Legal Business Name | LI DENTAL ASSOCIATION
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Dates
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Enumeration Date | 04/26/2017
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Last Update Date | 05/02/2017
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Provider Practice Location Address
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Address Line | 11908 DARNESTOWN RD SUITE E
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City | NORTH POTOMAC
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State | MD
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Zip | 20878-2295
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Country | US
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Telephone | 301-947-5300
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Fax | 301-947-9720
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Provider Business Mailing Address
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Address Line | 11908 DARNESTOWN RD SUITE E
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City | NORTH POTOMAC
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State | MD
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Zip | 20878-2295
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Country | US
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Telephone | 301-947-5300
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Fax | 301-947-9720
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Authorized Official
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Title or Position | OWNER
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Name | WEI LI
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Credential | DMD
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Telephone | 301-947-5300
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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 | 11898
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 16077
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License Number State | MD
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