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General NPI Number Information
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NPI Number | 1356931539
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Entity Type | Organization
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Legal Business Name | ADVANCED COSMETIC AND GENERAL DENTISTRY GROUP, PC
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Dates
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Enumeration Date | 01/21/2021
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Last Update Date | 01/21/2021
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Provider Practice Location Address
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Address Line | 1145 19TH ST NW STE 512
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City | WASHINGTON
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State | DC
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Zip | 20036-3715
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Country | US
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Telephone | 202-331-1644
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Fax |
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Provider Business Mailing Address
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Address Line | 18119 CASHELL RD
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City | OLNEY
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State | MD
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Zip | 20832-2003
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Country | US
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Telephone | 617-699-5557
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DAVID ESKOW
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Credential | DDS
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Telephone | 301-602-2455
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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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