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General NPI Number Information
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NPI Number | 1316249758
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Entity Type | Organization
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Legal Business Name | CABS DENTAL MANAGEMENT LLC
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Dates
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Enumeration Date | 11/17/2010
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Last Update Date | 11/17/2010
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Provider Practice Location Address
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Address Line | 4214 BENNING RD. N.E.
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City | WASHINGTON
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State | DC
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Zip | 20019-4518
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Country | US
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Telephone | 202-357-1445
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Fax | 202-399-8949
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Provider Business Mailing Address
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Address Line | 4214 BENNING RD. N.E.
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City | WASHINGTON
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State | DC
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Zip | 20019-4518
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Country | US
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Telephone | 202-357-1445
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Fax | 202-399-8949
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Authorized Official
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Title or Position | SECRETARY
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Name | DR. JOHN WALLACE SAUNDERS JR.
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Credential | DDS
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Telephone | 202-397-1445
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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 | DEN2111
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License Number State | DC
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